Effect of malnutrition on outcomes of hospitalisations for acute pulmonary embolism: a national inpatient database study
Background To evaluate the occurrence of malnutrition in pulmonary embolism (PE)-related hospitalisations and assess the impact of malnutrition on the outcomes of patients with PE.Methods A retrospective observational study using data extracted from the Nationwide Inpatient Sample from 2016 to 2018....
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
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| Series: | BMJ Nutrition, Prevention & Health |
| Online Access: | https://nutrition.bmj.com/content/early/2023/10/17/bmjnph-2023-000705.full |
| _version_ | 1797658105407864832 |
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| author | Parth Rali Ka U Lio Si Li Truong-An Ho Yichen Wang |
| author_facet | Parth Rali Ka U Lio Si Li Truong-An Ho Yichen Wang |
| author_sort | Parth Rali |
| collection | DOAJ |
| description | Background To evaluate the occurrence of malnutrition in pulmonary embolism (PE)-related hospitalisations and assess the impact of malnutrition on the outcomes of patients with PE.Methods A retrospective observational study using data extracted from the Nationwide Inpatient Sample from 2016 to 2018. Hospitalisations with a principal diagnosis of PE were obtained using International Classification of Diseases, Tenth Revision codes and divided into groups based on a secondary diagnosis of malnutrition.Results Of 563 135 PE hospitalisations, 30 495 (5.4%) had malnutrition. PE patients with malnutrition were older (mean age±SD, 69.1±14.5 vs 62.3±16.6, p<0.001) and with higher Charlson Comorbidity Index score (3 to 5, 24.8% vs 12.9%, p<0.001). Concurrent malnutrition was associated with higher adjusted OR (aOR) of in-hospital mortality (aOR 2.43, 95% CI 2.18 to 2.70, p<0.001), acute kidney injury (aOR 1.56, 95% CI 1.45 to 1.67, p<0.001), sepsis (aOR 4.37, 95% CI 3.79 to 5.03, p<0.001), shock (aOR 2.52, 95% CI 2.25 to 2.81, p<0.001), acidosis (aOR 2.55, 95% CI 2.34 to 2.77, p<0.001) and mechanical ventilation (aOR 2.95, 95% CI 2.61 to 3.33, p<0.001). Patients with PE and malnutrition had an increased mean length of stay (adjusted difference 3.39 days, 95% CI 3.14 to 3.65, p<0.001), hospital charges (adjusted difference US$34 802.11, 95% CI US$31 005.01 to US$38 599.22, p<0.001) and costs (adjusted difference US$8 332.01, 95% CI US$7489.09 to US$9174.94, p<0.001).Conclusion Concurrent PE and malnutrition were associated with worse outcomes. The study highlights the importance of identifying malnutrition in patients with PE to improve outcomes and reduce healthcare utilisation. |
| first_indexed | 2024-03-11T17:55:03Z |
| format | Article |
| id | doaj.art-6b4056e22323426d8ffcbc11631bdb17 |
| institution | Directory Open Access Journal |
| issn | 2516-5542 |
| language | English |
| last_indexed | 2024-03-11T17:55:03Z |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Nutrition, Prevention & Health |
| spelling | doaj.art-6b4056e22323426d8ffcbc11631bdb172023-10-17T18:10:07ZengBMJ Publishing GroupBMJ Nutrition, Prevention & Health2516-554210.1136/bmjnph-2023-000705Effect of malnutrition on outcomes of hospitalisations for acute pulmonary embolism: a national inpatient database studyParth Rali0Ka U Lio1Si Li2Truong-An Ho3Yichen Wang4Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USADepartment of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USADepartment of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USADepartment of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USADepartment of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USABackground To evaluate the occurrence of malnutrition in pulmonary embolism (PE)-related hospitalisations and assess the impact of malnutrition on the outcomes of patients with PE.Methods A retrospective observational study using data extracted from the Nationwide Inpatient Sample from 2016 to 2018. Hospitalisations with a principal diagnosis of PE were obtained using International Classification of Diseases, Tenth Revision codes and divided into groups based on a secondary diagnosis of malnutrition.Results Of 563 135 PE hospitalisations, 30 495 (5.4%) had malnutrition. PE patients with malnutrition were older (mean age±SD, 69.1±14.5 vs 62.3±16.6, p<0.001) and with higher Charlson Comorbidity Index score (3 to 5, 24.8% vs 12.9%, p<0.001). Concurrent malnutrition was associated with higher adjusted OR (aOR) of in-hospital mortality (aOR 2.43, 95% CI 2.18 to 2.70, p<0.001), acute kidney injury (aOR 1.56, 95% CI 1.45 to 1.67, p<0.001), sepsis (aOR 4.37, 95% CI 3.79 to 5.03, p<0.001), shock (aOR 2.52, 95% CI 2.25 to 2.81, p<0.001), acidosis (aOR 2.55, 95% CI 2.34 to 2.77, p<0.001) and mechanical ventilation (aOR 2.95, 95% CI 2.61 to 3.33, p<0.001). Patients with PE and malnutrition had an increased mean length of stay (adjusted difference 3.39 days, 95% CI 3.14 to 3.65, p<0.001), hospital charges (adjusted difference US$34 802.11, 95% CI US$31 005.01 to US$38 599.22, p<0.001) and costs (adjusted difference US$8 332.01, 95% CI US$7489.09 to US$9174.94, p<0.001).Conclusion Concurrent PE and malnutrition were associated with worse outcomes. The study highlights the importance of identifying malnutrition in patients with PE to improve outcomes and reduce healthcare utilisation.https://nutrition.bmj.com/content/early/2023/10/17/bmjnph-2023-000705.full |
| spellingShingle | Parth Rali Ka U Lio Si Li Truong-An Ho Yichen Wang Effect of malnutrition on outcomes of hospitalisations for acute pulmonary embolism: a national inpatient database study BMJ Nutrition, Prevention & Health |
| title | Effect of malnutrition on outcomes of hospitalisations for acute pulmonary embolism: a national inpatient database study |
| title_full | Effect of malnutrition on outcomes of hospitalisations for acute pulmonary embolism: a national inpatient database study |
| title_fullStr | Effect of malnutrition on outcomes of hospitalisations for acute pulmonary embolism: a national inpatient database study |
| title_full_unstemmed | Effect of malnutrition on outcomes of hospitalisations for acute pulmonary embolism: a national inpatient database study |
| title_short | Effect of malnutrition on outcomes of hospitalisations for acute pulmonary embolism: a national inpatient database study |
| title_sort | effect of malnutrition on outcomes of hospitalisations for acute pulmonary embolism a national inpatient database study |
| url | https://nutrition.bmj.com/content/early/2023/10/17/bmjnph-2023-000705.full |
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