Impact of Malnutrition on Hospitalization Outcomes for Older Adults Admitted for Sepsis

Abstract

BackgroundMalnutrition is a major determinant of health outcomes among older adults’ population. Our goal was to evaluate the impact of malnutrition on hospitalization outcomes for older adults who were admitted with a diagnosis of sepsis. MethodsThe National Inpatient Sample (NIS) was queried for all patients who were admitted with a primary diagnosis of sepsis from January to December 2016. These patients were identified using the International Classification of Diseases—Tenth Revision (ICD-10) diagnosis code: "A419". Patients who were diagnosed with malnutrition were identified using ICD-10 codes “E43, E440, E441, E45, E46”. Outcomes of hospitalization were modeled using logistic regression for binary outcomes and generalized linear models for continuous outcomes. ResultsOverall, a total of 808,030 patients were admitted for sepsis. Those diagnosed with malnutrition were 15.6% (126,335). The mean age (standard error of the mean (SEM)) was 78 years (0.03). On multivariate analysis, malnutrition correlated with an increased odd for mortality adjusted OR (a-OR)1.20 (95%CI: 1.15-1.26) <0.001, septic shock a-OR 1.50 (95%CI: 1.44-1.57) <0.001 and intubation a-OR 1.45 (95%CI: 1.38-1.52) <0.001. It was also associated with higher odds for acute kidney injury and stroke. Malnutrition correlated with a 53% increase in the length of stay with mean ratio 1.53 (95%CI: 1.51-1.56) p<0.01 and a 54% increase in cost with mean cost ratio 1.54 (95%CI: 1.51-1.58) p<0.001. ConclusionAmong the geriatric's population diagnosed with sepsis, malnutrition is an independent predictor for poor hospitalization outcomes.