Abstract 4147486: In-Hospital Outcomes in Patients with Takotsubo Cardiomyopathy and Malnutrition: Analysis from the National Inpatient Sample

Introduction: Takotsubo, or stress cardiomyopathy, can result in substantial morbidity and mortality. Malnutrition can affect the prognosis of hospitalized patients. Objective: To compare Takotsubo cardiomyopathy outcomes between patients with severe protein-calorie and mild-moderate malnutrition. Methods: We queried the National Inpatient Sample (NIS) from 2016 to 2020 for adults hospitalized with Takotsubo cardiomyopathy and severe or mild-moderate protein-calorie malnutrition. The primary outcome was inpatient mortality. Secondary outcomes included cardiac arrest, cardiogenic shock, respiratory failure/mechanical ventilation, acute kidney injury, vasopressor use, palliative consult, length of stay (LOS), and total hospital charges (TOTCHG). Multivariate logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs). Results: Among 159,395 patients with Takotsubo cardiomyopathy, 10,638 had severe protein-calorie malnutrition, while 5,907 had mild-moderate malnutrition. Respectively, the groups had mean age 67 vs. 68 years, male sex 27.0% vs. 24.8%, and White race 76.5% vs. 78.6% (Table 1A). Compared to the mild-moderate malnutrition group, the severe malnutrition group had higher odds of in-hospital mortality [OR 1.53, CI (1.12-2.07), P=0.006], palliative consults [OR 1.74 CI (1.29-2.34) P<0.0001], longer LOS (15 vs. 13 days), and higher charges ($215,441 vs. $188,171) (Table 1B). Other outcomes showed no significant differences. Conclusion: In patients with Takotsubo cardiomyopathy, severe protein-calorie malnutrition significantly worsens clinical outcomes.