Inferior Outcomes of Patients With Acute Myocardial Infarction and Comorbid Protein-Energy Malnutrition.
JPEN J Parenter Enteral Nutr
; 44(3): 454-462, 2020 03.
Article
em En
| MEDLINE
| ID: mdl-31317574
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 (11) 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 (AOR1.81 [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.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Desnutrição Proteico-Calórica
/
Infarto do Miocárdio
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
Limite:
Aged
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Female
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Humans
Idioma:
En
Revista:
JPEN J Parenter Enteral Nutr
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Estados Unidos