Impact of Malnutrition on the Outcomes in Patients Admitted with Heart Failure

Heart failure, a major public health concern, significantly contributes to hospital admissions. This study evaluates the impact of malnutrition on both patient and hospital outcomes in heart failure admissions, with a specific focus on variations in outcomes based on the severity of malnutrition. Utilizing the National Inpatient Sample (NIS) database, this retrospective cohort study included adult patients admitted with a principal diagnosis of heart failure. Malnutrition was identified using the well-validated ICD 10 codes. We compared outcomes between patients with and without malnutrition, focusing on mortality, length of stay (LOS), hospital charges, cardiac arrest, and cardiogenic shock. Out of 1,110,085 heart failure patients, 36,522 (3.29%) were malnourished. Malnourished patients exhibited significantly higher adjusted in-hospital mortality rates (aOR 3.32; 95% CI 3.03-3.64), longer LOS (mean increase of 4.67 days; < 0.001), and higher hospital charges (mean increase of USD 77,416.9; < 0.01). Increased rates of cardiac arrest (aOR 2.39; 95% CI 1.99-2.86; < 0.001) and cardiogenic shock (aOR 3.74; 95% CI 3.40-4.12; < 0.001) were also noted in malnourished patients. Severely malnourished patients faced worse outcomes compared to those with mild to moderate malnutrition. Heart failure patients with malnutrition experience higher mortality rates, longer hospital stays, increased hospitalization charges, and greater complication rates, including cardiac arrest and cardiogenic shock, compared to non-malnourished patients. Outcomes deteriorate with the increasing severity of malnutrition. Timely and individualized nutritional interventions may significantly improve outcomes for heart failure admissions.