(P29-032-23) Spectrum of Inpatient Comorbidities Associated With Malnutrition

Objectives: Hospitalized patients tend to have comorbidities that place them at high risk of developing malnutrition. However, these patients' demographic and clinical characteristics have not been thoroughly examined. The aim of our study was to investigate the prevalence and clinical correlates of hospitalized patients with a malnutrition diagnosis.

Methods: Our cross-sectional study used the Nationwide Readmission Database (NRD) for 2016-2019. First, we extracted all cases older than 18 years that included a diagnosis of malnutrition. Appropriate survey and domain analyses were applied to obtain national estimates using SAS 9.4.

Results: We identified 8,297,250 admissions with malnutrition. Of those, 40% of the study cohort (3,316,717 cases) represented elderly patients (mean age 83 years; 42.4% male) while the remaining individuals consisted of patients younger than 75 years old (mean age 57 years; 52.4% male). Most younger patients were of low or average socioeconomic status (60%) in comparison to an even distribution at each level of socioeconomic status for the elderly (p < 0.0001). Younger patients with malnutrition had a significantly higher prevalence of malignancy, psychiatric illness (depression or psychosis), liver disease, alcohol and drug abuse, pancreatitis, inflammatory bowel disease, and AIDS. In comparison, the most common malnutrition-associated comorbidities in the elderly were cardiovascular disease including heart failure (HF) (34%), dementia (31%), chronic renal disease (31%), and encephalopathies (20%). Overall, inpatient mortality for malnourished patients was high (7.9%) compared to the average mortality of 2% for adult hospitalized patients. In-patient mortality was higher for the elderly than younger patients (9.3% vs. 6.9%, p< 0.0001). The most important predictors for inpatient mortality among malnourished patients were acute encephalopathy, malignancy, HF, liver failure, renal failure, and being older than 75 years.

Conclusions: In comparison to younger patients, malnutrition-related comorbidities in the hospitalized elderly population are associated with worse inpatient mortality. Considerable importance should be placed on early identification and nutritional intervention of malnutrition to help delay or prevent associated poor health outcomes.

Funding Sources: None