Malnutrition is Associated with Worse Outcomes in Advanced Heart Failure Recipients.

Advanced HF therapy includes heart transplantation and Left Ventricular Assist Device implantation (LVAD). Readmission studies about malnutrition in patients receiving advanced HF therapy at the national level are limited. Our cross-sectional study used Nationwide Readmission Database (NRD) for 2016-2019. First, we extracted all cases older than 18 years that received advanced heart failure therapy during the index admission. Appropriate survey and domain analyses were applied using SAS 9.4. We identified 27,409 discharges who received advanced HF therapy. Malnutrition was present in 27% of the study cohort (or 7,443 cases). Patients with malnutrition were slightly older than those without malnutrition (mean age 56 years vs. 54 years, p<0.001) and had fewer women (22% vs. 24%, p<0.001). Patients with malnutrition had a higher prevalence of acute myocardial infarction (AMI), coagulopathy, peripheral vascular disease (PVD), and chronic (liver and renal) diseases (p<0.02). Malnourished patients also had significantly higher sudden cardiac arrest (11.9% vs. 8.8%, p<0.001), inpatient mortality during index admission (13.8% vs. 7.1%, p<0.001), length of stay (mean of 54 days vs. 32 days, p<0.001), and all-cause 30-day readmission rates (26% vs. 24%, p<0.003). Inpatient mortality on readmission was also higher in those with malnutrition (0.9% vs. 0.6%, p<0.1). Even after adjusting for age, gender, AMI, coronary artery disease, PVD, malignancy, depression, dementia, cerebrovascular disease on admission, acute encephalopathy, coagulopathy, and chronic (liver, renal, thyroid, and lung) diseases, the presence of malnutrition continued to be associated with higher inpatient mortality compared to those without malnutrition (OR 1.58[1.35-1.53]). In patients receiving advanced HF therapy, malnutrition is associated with worse outcomes during index and subsequent hospitalizations. [ABSTRACT FROM AUTHOR]