Impact of Malnutrition in Patients With Infective Endocarditis

Background: Effects of malnutrition on patients with infective endocarditis (IE) have not been fully studied. Because malnutrition is associated with poor health, we hypothesized that among patients with IE, those with malnutrition would have more negative in-hospital outcomes. Methods: The National Inpatient Sample was used to identify adults ≥18 years old with IE. We compared outcomes of in-hospital mortality, morbidity, valvular interventions, and utilization of resources between individuals with and without malnutrition. Results: 11,939 adults ≥18 years were hospitalized with IE, 2035 had a secondary diagnosis for malnutrition. There were no significant differences in age (mean age ± SEM: 55.6 ± 1.0 vs 54.3 ± 0.4 years, P =.21) or sex (female: 36.7%; 743/2,035 vs 37.5%; 3,717/9,904, P =.69) in patients with and without malnutrition. Patients with malnutrition had more comorbidities (Charlson comorbidity score ≥3: 36%; 732/2,035 vs 30.7%; 3,040/9,904, P =.04). Despite similar adjusted in-hospital mortality (adjusted odds ratio [aOR], 1.4; 95% CI, 0.8–1.5; P =.23), malnourished patients were more likely to develop sepsis (aOR, 1.7; 95% CI, 1.2–2.4; P <.01) and had higher odds of mitral-valve (aOR, 1.7; 95% CI, 1.2–2.4; P <.01) repairs/replacements. Patients with malnutrition also had increased lengths of stay (adjusted mean difference [aMD], 4.7 days; 95% CI, 2.9–6.5 days; P <.01) and hospital charges (aMD, $36,052; 95% CI, $14,935–$57,168; P <.01). Conclusions: Patients with malnutrition and IE are at risk for high morbidity, valvular repairs/replacements, and use of hospital resources.