Abstract 785: Epidemiology, clinical outcomes, and healthcare resource utilization in multiple myeloma patients with protein-energy malnutrition hospitalized for acute congestive heart failure: A comprehensive population-based analysis

Abstract Introduction: Multiple myeloma (MM) is often associated with heart failure, which can result from a high- output state, light-chain cardiac amyloidosis, or treatments such as proteasome inhibitors. Common MM-associated complications like anemia can further exacerbate heart failure, leading to acute decompensation and increased rates of hospitalization. Protein-energy malnutrition (PEM) is common in MM patients and is linked to poorer outcomes and longer hospital stays in various cancers. However, the impact of PEM on MM patients with acute congestive heart failure (ACHF) has not been well studied. This research aims to explore how PEM affects in- hospital outcomes in MM patients with ACHF. Methods: We identified adult patients with MM from the National Inpatient Sample who were admitted with ACHF as the principal diagnosis from 2018 to 2021, using ICD-10 codes. The cohort was categorized based on the presence or absence of PEM, and we applied complex sampling weights to ensure national representativeness. Our primary outcome was all-cause mortality, and we analyzed several secondary outcomes. We used multivariate regression models to evaluate outcome disparities between the groups, with statistical significance set at p < 0.05. Results: We identified a total of 2, 390 adults with MM who were admitted with a principal diagnosis of ACHF from 2018 to 2021. Among these, 395 patients (16.5%) had a concurrent diagnosis of PEM. The mortality rate was 5.2% in the entire cohort and 11.4% in the PEM group. The PEM group had a higher proportion of female patients (59.5% vs. 43.9%, p=0.01). Patients with PEM had higher odds of all-cause mortality, with an adjusted odds ratio (aOR) of 2.64 (95% confidence interval [CI] 1.07-6.48). They also had higher odds of experiencing acute kidney injury (aOR 1.86, 95% CI 1.05-3.30), requiring mechanical ventilation (aOR 15.17, 95% CI 1.98-116.22), experiencing cardiogenic shock (aOR 3.73, 95% CI 1.27-10.92), and needing vasopressor support (aOR 4.96, 95% CI 1.37-17.90). Furthermore, patients with PEM faced longer hospital stays (9.8 vs. 5.8 days), with an adjusted incidence rate ratio (aIRR) of 1.55 (95% CI 1.25-1.92), and higher hospitalization charges ($118, 775 vs. $59, 505), with an aIRR of 1.71 (95% CI 1.28-2.28). Conclusion: Our study found that MM patients with PEM admitted for ACHF had significantly higher odds of all-cause mortality and other adverse clinical outcomes compared to those without PEM. In addition, these patients experienced longer hospital stays and higher hospitalization charges. These findings underscore the importance of addressing PEM in the management of MM patients with ACHF to improve clinical outcomes and reduce healthcare resource utilization. Citation Format: Adamsegd I. Gebremedhen, Abdu Mohammed, Mamdouh Souleymane, Michael Fatuyi, Malik Samardali, Kemnasom Nwanwene, Toni O. Pacioles. Epidemiology, clinical outcomes, and healthcare resource utilization in multiple myeloma patients with protein-energy malnutrition hospitalized for acute congestive heart failure: A comprehensive population-based analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 785