D-1 | Disparities in in-Hospital Outcomes in Cardiogenic Shock Patients With Protein-Calorie Malnutrition

Cardiogenic shock (CS) is a life-threatening condition. Protein-calorie malnutrition (PCM) often affect critically ill patients however its role in CS is not fully understood. Our aim was to characterize the patient demographics and to investigate the impact of PCM on CS. This was a retrospective cohort study using the 2019 Nationwide Inpatient Sample database to identify admissions in adults with diagnoses of CS and PCM. Multivariate linear and logistic regression models were adjusted for demographic variables. Primary outcome was all-cause mortality, and secondary outcomes were length of stay (LOS) and total charge in USD. Out of 191835 admissions with CS, 26710 had PCM. Compared to Non-PCM-CS cohort, PCM-CS Cohort had more females (39.58% vs 37.76%,p<0.05), Black (18.81% vs 15.58%,p<0.001), API (3.78% vs 3.10%,p<0.05), Medicare (63.95% vs 60.40%,p<0.001), Medicaid (14.23% vs 12.43%,p<0.001), fewer White (62.49% vs 65.89%,p<0.001), private insurance (16.87% vs 20.38%,p<0.001) and no difference in age (66.15 vs 65.65 years,p=0.081). PCM-CS Cohort was associated with more alcohol abuse (6.20% vs 5.21%,p<0.01), dementia (6.93% vs 5.18%,p<0.001), leukemia (1.16% vs 0.73%,p<0.01), lymphoma (1.95% vs 1.01%,p<0.001), metastatic cancer (4.23% vs 1.83%,p<0.001), PVD (14.47% vs 12.89%,p<0.01), cerebral infarction (5.62% vs 3.45%,p<0.001) and less NSTEMI (1.96% vs 14.86%,p<0.001), systolic HF (5.90% vs 33.38%,p<0.001), cerebral hemorrhage (0.32% vs 1.14%,p<0.001), STEMI (9.10% vs 17.04%,p<0.001), depression (8.03% vs 9.06%,p<0.05), diabetes mellitus (28.44% vs 31.59%,p<0.001), and hypertension (46.78% vs 49.33%,p<0.01). PCM-CS cohort had lower mortality rate (28.12% vs 32.25%,p<0.001), mortality OR 0.78 (95%CI 0.72-0.84,p<0.001), higher mean LOS (20.20 vs 9.96 days,p<0.001), and higher mean total hospitalization charge ($430,161.60 vs $227,459.10,p<0.001). Among patients admitted with CS, the presence of PCM was associated with lower all-cause mortality rate, odds of mortality, higher LOS and total hospitalization charge. The presence of PCM was associated with more female, Black, API, Medicare, dementia, and less cardiovascular comorbidities.