P2597 - The Influence of Protein-Calorie Malnutrition on Hospital Outcomes in Inflammatory Bowel Disease Patients: Insights From National Inpatient Sample Analysis

Natchaya Polpichai, MD¹, Natapat Chaisidhivej, MD², Passisd Laoveeravat, MD³, Sakditad Saowapa, MD⁴, Pojsakorn Danpanichkul, MD⁴, Emily Shu-Yen Chan, MD, MSc¹, Thanathip Suenghataiphorn, MD⁵, Noppachai Siranart, MD^6
1Weiss Memorial Hospital, Chicago, IL; ²University of Nebraska Medical Center, Omaha, NE; ³University of Kentucky, Lexington, KY; ⁴Texas Tech University Health Sciences Center, Lubbock, TX; ⁵Griffin Hospital, Derby, CT; ⁶Brigham and Women's Hospital, Boston, MA

Introduction: Inflammatory Bowel Disease (IBD) presents a complex interplay of inflammatory processes and poses a significant burden on patients and healthcare systems globally. Malnutrition, particularly protein-calorie malnutrition (PCM), is recognized as a potential complicating factor in IBD management. This study aimed to investigate the impact of PCM on hospital outcomes among IBD patients.

Methods: A retrospective analysis of 2016-2020 National Inpatient Sample (NIS) data identified adults with IBD, categorized by the presence of PCM. Hospitalization characteristics, comorbidities, and outcomes were compared between groups. Primary outcomes included in-hospital mortality, length of stay (LOS), and total hospital charges (THC). Secondary outcomes were IBD complications and hospital outcomes. Linear and multivariate logistic regression analysis was performed, with p-values ≤ 0.05 indicating statistical significance.

Results: Among 1,596,925 IBD patients, 59,310 had PCM. IBD patients with PCM had a higher rate of in-hospital mortality (2.31% vs 1.61%; P < 0.001), longer mean LOS (8.77 vs. 5.21 days; P < 0.001), and a higher mean THC (89997.1 vs 57008.03; P < 0.001). After adjustment for confounders, IBD patients with PCM exhibited significantly higher odds of in-hospital mortality (adjusted odds ratio (aOR)= 1.20), sepsis (aOR=1.58), septic shock (aOR=1.69), acute kidney injury (aOR=1.48), paralytic ileus (aOR=1.99), Clostridioides difficile infection (aOR=1.68), intra-abdominal abscess (aOR=2.28), toxic megacolon (aOR=3.40), bowel perforation (aOR=1.78), acute blood loss anemia (aOR=1.57), acute venous thromboembolism (aOR=1.45), bacterial pneumonia (aOR=1.59), transfusion (aOR=1.62),mechanical ventilator (aOR=1.87), and vasopressor use (aOR=1.62), but lower risks of acute myocardial infarction (P= 0.003).

Discussion: Our study shows that IBD patients with PCM had higher in-hospital mortality, mean THC, and longer mean LOS, as well as more adverse hospital outcomes, but a lower risk of acute myocardial infarction. This might be explained by the fact that patients with PCM have a lower risk of metabolic syndrome. These findings underscore the critical impact of PCM on hospital outcomes in IBD patients, emphasizing the need for proactive nutritional management as part of comprehensive disease care strategies.


Disclosures:


Natchaya Polpichai, MD¹, Natapat Chaisidhivej, MD², Passisd Laoveeravat, MD³, Sakditad Saowapa, MD⁴, Pojsakorn Danpanichkul, MD⁴, Emily Shu-Yen Chan, MD, MSc¹, Thanathip Suenghataiphorn, MD⁵, Noppachai Siranart, MD⁶. P2597 - The Influence of Protein-Calorie Malnutrition on Hospital Outcomes in Inflammatory Bowel Disease Patients: Insights From National Inpatient Sample Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.