MON-358 The Impact of Malnutrition on Cardiovascular Outcomes Among Hospitalized Patients with Thyrotoxicosis: A Comprehensive National Inpatient Analysis in The United States

Abstract Disclosure: A. Telesford: None. K. Peterkin: None. S. Mc Lean: None. C. Lezama: None. M. Shams: None. Background:Hyperthyroidism significantly impacts the cardiovascular system, disrupting normal heart function and contributing to elevated cardiovascular mortality. This review aims to explore the role of malnutrition as it relates to inpatient outcomes, with a particular emphasis on the cardiovascular burden in patients hospitalized with thyrotoxicosis. Methods: We utilized the National Inpatient Sample database from 2017 to 2020 to identify hospitalized patients with thyrotoxicosis, using relevant ICD-10 diagnostic codes. Inclusion criteria encompassed adult patients, categorized into two groups based on the presence of malnutrition (protein-energy). We evaluated malnutrition's impact on in-hospital outcomes, with the primary outcome being in-hospital mortality, and secondary outcomes including length of stay (LOS), total hospital charges (THC), association with atrial tachyarrhythmia (AT; fibrillation/flutter), ventricular tachyarrhythmia (VT; fibrillation/tachycardia), acute myocardial infarction (AMI), congestive heart failure (CHF), and cardiac arrest. Multivariable regression analyses were conducted, adjusting for patient and hospital characteristics. Results: The study included 6,189 patients with thyrotoxicosis, of whom 461 (7.45%) had concomitant malnutrition. Multivariate analysis revealed that the presence of malnutrition was associated with an increased odds of in-patient mortality (adjusted odds ratio [aOR] 3.81, 95% confidence interval [CI] 1.56-9.32; P=0.00). Patients with malnutrition experienced increased LOS (2.57 days, 95% CI 1.91-3.23; P=0.00), higher THC ($18,815.63, 95% CI 5840.85-31790.41; P=0.00), decreased odds of associated AT (aOR 0.73, 95% CI 0.56-0.95; P=0.02), and increased odds of associated VT (aOR 1.98, 95% CI 1.13-3.48; P<0.02). No differences in association in relation to AMI, CHF, or cardiac arrest were detected. Conclusion: Malnutrition is a significant determinant of poor outcomes in patients hospitalized with thyrotoxicosis. It is associated with higher in-patient mortality, prolonged hospital stays, and increased healthcare costs, as well as a distinct pattern of cardiovascular complications, including increased odds of ventricular tachyarrhythmia. These findings underscore the critical importance of addressing nutritional status as part of the care for patients with thyrotoxicosis to mitigate adverse outcomes. Presentation: Monday, July 14, 2025