Abstract: PUB188
Effects of Malnutrition on Hospital- Based Outcomes in Kidney Transplant Recipients: A Retrospective Analysis
Session Information
Category: Health Maintenance, Nutrition, and Metabolism
- 1500 Health Maintenance, Nutrition, and Metabolism
Authors
- Lakhani, Sejal, Lehigh Valley Health Network, Allentown, Pennsylvania, United States
- Lakhani, Sonal, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
- Zafar, Muhammad Usman, Lehigh Valley Health Network, Allentown, Pennsylvania, United States
Background
Malnutrition means unbalanced nutrition. It is known that pre-kidney transplant malnutrition increases the risk of adverse clinical outcomes including delayed graft function, making pre-operative optimization vital. Following transplant, patients are predisposed to metabolic disorders such as dyslipidemia and glucose intolerance. Moreover, most recipients present with chronic kidney graft disease at long term follow up and therefore the nutritional status of renal transplant patients requires close monitoring. In this study we utilize the National Inpatient Sample (NIS) to understand the effect of malnutrition on inpatient mortality in kidney transplant patients.
Methods
This is a retrospective study utilizing data obtained from the NIS for 2017 - 18. We used International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10) codes to identify hospitalizations with kidney transplant and malnutrition. Outcomes assess included inpatient mortality, length of stay (LOS) and hospital cost. We performed multivariate logistic and linear regression analysis in STATA MP 19 to account for comorbidities and cofounding variables.
Results
The study analyzed 72,886 hospitalizations, and with appropriate weights can be extrapolated to 364,429 hospitalizations. The mean age was 60 years. Among these 56% were females.
It was observed that odds of inpatient mortality are higher among patients with malnutrition (Odds Ratio (OR) 2.807, 95% Confidence Interval (CI) 2.443 – 3.224). Other significant factors included history of congestive heart failure (OR 1.786, 95% CI 1.583 – 2.013), stroke (OR 10.517, 95% CI 8.208 – 13.476), and weekend admission (OR 1.153, 95% CI 1.02 – 1.302).
Mean LOS was 5 days. Patients with malnutrition stayed longer by 1 day (Coef. 5.852, 95% CI 5.405 – 6.2898). LOS was higher in patients with a history of heart failure and in those with an acute kidney injury. Teaching hospitals had higher LOS by 1 day.
The total cost utilization for hospitalizations from malnutrition is higher by $79,325 (95% CI 68107.46 – 90545.66). Other factors incurring higher cost include history of stroke and obesity.
Conclusion
Among hospitalized renal transplant patients those that have concurrent malnutrition have an increased risk of adverse effects inpatient outcomes that include, inpatient mortality, hospital length of stay and total hospitalization cost.