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MALNUTRITION IS ASSOCIATED WITH INCREASED HOSPITAL LENGTH OF STAY AND MORTALITY AMONG ADULT COVID-19 PATIENTS
Gastroenterology ; 162(7):S-171, 2022.
Article in English | EMBASE | ID: covidwho-1967254
ABSTRACT
Background. Malnutrition has been linked to longer hospital stays and adverse health economic outcomes. In COVID-19, there is a paucity of data on whether malnutrition is associated with adverse outcomes in the hospital setting. Methods. This is a retrospective cohort study consisting of 4,311 COVID-19 adult (18 years and older) inpatients at five Johns Hopkins affiliated hospitals between March 1, 2020, and December 3, 2020. Patient data were derived from their COVID-19 database JH-CROWN The COVID-19 Precision Medicine Analytics Platform (PMAP) Registry and extracted using Python 3, version 3.7.5, kernel in JupyterLab, version 1.1.4. Malnourishment among patients was identified as those who were malnutrition nutrition risk screen positive upon admission by use of the malnutrition universal screening tool (MUST) and confirmed by registered dietitians, Statistics were conducted with SAS v9.4 (Cary, NC) software to examine the effect of malnutrition on mortality and hospital length of stay among COVID-19 inpatient encounters while accounting for possible covariates in linear regression analysis predicting log-transformed length of stay. Results. COVID-19 patients who are older, male, or have lower BMIs have a higher likelihood of mortality (Table 1). In the linear regression model, for every 1% increase in BMI, the length of stay decreased by 0.38% (p<0.001) (Table 2). Differences in race (p=0.001) (Table 1), were associated with differences in the likelihood of mortality and length of stay;being Asian (p=0.0029), Black (p<0.001), or Other (p<0.001) were associated with decreased length of stay compared to Whites (Table 2). Patients with diabetes, hypertension, diarrhea, COPD, and malnutrition were more likely to have higher mortality (p<0.001) (Table 1) and more likely to have a longer hospital length of stay (p<0.001) (Table 2). Overall, 12.9% (555/4,311) of adult COVID-19 patients were diagnosed with malnutrition and were associated with an 87.9% (p<0.001) (Table 2) increase in hospital length of stay. Differences in the source of admission to the hospital affected the likelihood of mortality (p<0.001) (Table 1) and length of stay (Table 2). Conclusions. In a cohort of COVID-19 adult inpatients, malnutrition was associated with a higher likelihood of mortality and increased hospital length of stay. In the linear regression model, malnutrition was associated with an increase in the length of stay by 87.9%. Interestingly, decreases in BMI were associated with increased hospital length of stay. Race and admission source also plays a key role in affecting a patient's hospital length of stay and mortality. These results support the idea that malnutrition appears to be a predictor for COVID-19 inpatient outcomes similar to that of other known highrisk comorbidities like diabetes, hypertension, and COPD.(Table Presented)(Table Presented)
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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Observational study / Prognostic study / Risk factors Language: English Journal: Gastroenterology Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Observational study / Prognostic study / Risk factors Language: English Journal: Gastroenterology Year: 2022 Document Type: Article