e23091 Background: Nutrition is a critical yet frequently under-recognized determinant of clinical outcomes in patients with cancer. Malnutrition and morbid obesity have been linked to adverse outcomes. Despite advances in the management of hematologic malignancies, patients with poor nutritional status remain particularly susceptible to complications during hospitalization, including increased mortality. This study examined national-level data on the association of malnutrition and morbid obesity with inpatient mortality among patients with hematologic malignancies, an area in which existing data remain limited. Methods: We conducted a cross-sectional study using the 2021–2022 National Inpatient Sample database. Adults with hematologic malignancies were identified via ICD-10 codes. Nutritional status was defined by the codes for malnutrition and morbid obesity. The primary outcome was inpatient mortality. Sociodemographic variables included age, sex, race, payer, and median household income. To adjust for illness severity, a composite variable was created based on sepsis, respiratory failure, ventilation, or dialysis-requiring AKI. Multivariable logistic regression assessed factors linked to inpatient mortality. Results: A total of 1,202,329 hospitalizations were included. The median age was 69 years, and 33.8% of patients were aged ≥75 years. Patients were predominantly male (57.2%) and White (68.7%); 11.7% were Black and 10.9% Hispanic. Medicare was the most common payer (58.1%). Non-Hodgkin lymphoma (34.6%) and multiple myeloma (19.7%) were the most frequent malignancies. Malnutrition was present in 15.2% of hospitalizations, and 4.8% had morbid obesity. Overall, 29.4% met criteria for critical illness, and inpatient mortality was 6.1%. After adjustment, malnutrition was independently associated with increased inpatient mortality (adjusted OR 1.56, p < 0.001), whereas morbid obesity was associated with lower mortality (adjusted OR 0.93, p < 0.001). Critical illness was the strongest predictor of mortality (adjusted OR 5.29, p < 0.001). Older age, male sex, racial and ethnic minority status, lower neighborhood income, non-Medicare insurance, and acute myeloid leukemia were also associated with higher mortality. Conclusions: Among hospitalized patients with hematologic malignancies, malnutrition is a strong independent predictor of inpatient mortality, while morbid obesity is associated with lower mortality. Persistent sociodemographic disparities highlight the ongoing impact of nutritional and socioeconomic vulnerability on inpatient outcomes.
Amaeshi et al. (Thu,) studied this question.