Inferior Outcomes of Patients With Acute Myocardial Infarction and Comorbid Protein-Energy Malnutrition

Adeyinka Charles Adejumo, Kelechi Lauretta Adejumo, Oluwole Muyiwa Adegbala, Ngozi Enwerem, Andrew Ofosu, Olalekan Akanbi, Daniel Obadare Fijabi, Olumuyiwa Akinbolaji Ogundipe, Lydie Pani, Adedayo Adeboye

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Protein-energy malnutrition (PEM) diminishes amino acid and energy availability, impairing the body's healing capability after injury, such as in myocardial damage following acute myocardial infarction (AMI). Aims: We sought to investigate the influence of PEM on clinical outcomes of AMI. Methods: We identified records with a primary discharge diagnosis of AMI from the Nationwide Inpatient Sample (2012–2014), stratified by concomitant PEM. We matched PEM to no-PEM (1:1) using a greedy algorithm–based propensity methodology and estimated the impact of PEM on health outcomes (SAS 9.4). Results: Of the 332,644 hospitalizations for AMI, 11,675 had concomitant PEM accounting for roughly $US 1.5 billion and over 119,792 hospital days. PEM was associated with older age (74.43- vs. 66.90-years; P < 0.0001), female sex (49.19% vs. 38.44%; P < 0.0001), black race (12.78% vs. 10.46%; P < 0.0001), and higher comorbidity burden (Deyo > 3: 32.77% vs. 16.69%; P < 0.0001). After propensity matching, PEM was associated with higher mortality (Adjusted odds ratio [AOR]: 1.59 [1.46–1.73]), cardiogenic shock (AOR: 2.26 [2.08–2.44]), discharge to secondary facilities (AOR: 2.21 [2.10–2.33]), charges ($135,500 [$131,956–139,139] vs. $81,084 [$79,241–82,970]), cardiac artery bypass surgery (AOR:1.81 [1.66–1.97]), intra-aortic balloon pump placement (AOR: 1.83 [1.65–2.04]) and longer length of stay (10.15- vs. 5.52-days). Conclusions: PEM is a predisposing factor for devastating clinical outcomes among AMI hospitalizations. Higher prevention, identification and management of PEM among high-risk individuals (older age, female sex, and black race) residing in the community are needed.

Original languageEnglish (US)
Pages (from-to)454-462
Number of pages9
JournalJournal of Parenteral and Enteral Nutrition
Volume44
Issue number3
DOIs
StatePublished - Mar 1 2020
Externally publishedYes

Keywords

  • charges
  • discharge disposition
  • length of stay
  • mortality
  • shock

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Fingerprint

Dive into the research topics of 'Inferior Outcomes of Patients With Acute Myocardial Infarction and Comorbid Protein-Energy Malnutrition'. Together they form a unique fingerprint.

Cite this