Abstract
Abstract only
Introduction:
Protein energy malnutrition (PEM) is associated with adverse clinical outcomes for various cardiac diseases, but its effect on outcomes of hypertensive emergencies (HTNE) has not been studied. We examined the impact of PEM on in-hospital outcomes of HTNE using the largest inpatient database in the United States.
Methods:
We reviewed the National Inpatient Database from 2017 to 2018 to identify admissions for HTNE and stratified them to those with PEM (PEM+) and without PEM (PEM-). Multivariable logistic regression was used to compare categorical and continuous variables after adjusting for confounders. Primary outcome included in-hospital mortality. Secondary outcomes included mean length of stay (LOS), total hospital charge (THC), and acute kidney injury (AKI).
Results:
Of 749,115 admissions with HTNE, 34,555(4.6 %) had PEM. A total of 27,855 (3.72%) deaths were observed inpatient for HTNE. Among PEM + cohort, 2,310 of 34,555 (6.68 %) died compared with 25,545 of 714,560 (3.57 %) among PEM- cohort [AOR 1.29, 95% CI 1.17-1.45, p<0.001]. Both LOS (7 days,95% CI [6.63]-7.38, p<0.001) and THC ($86,928, 95% CI [61,632]-74,831, p<0.001) were significantly higher in PEM + cohort. PEM + cohort also had higher odds of AKI [5360 of 35,555(44.5%) vs 22,950 of 714,560 (31.12%);(AOR 1.39, 95% CI 1.31-1.46, p<0.001)].
Conclusion:
Concomitant diagnosis of PEM in HTNE is associated with higher odds of in-hospital mortality and AKI . It also increases burden on healthcare.Higher vigilance and early risk stratification may be important for better outcomes in HTNE admissions with PEM. Further prospective studies are required to evaluate the measures to mitigate negative outcomes.