Protein Calorie Malnutrition Effect on Clinical Outcomes And Resource Utilization in Patients Admitted with Acute Pancreatitis And Dyslipidemia

Background/Synopsis

Severe acute pancreatitis can cause a hypermetabolic state, leading to increased energy expenditure and nutrient requirements. This may contribute to protein-calorie malnutrition (PCM). Malnutrition, in turn, can affect lipid metabolism, potentially exacerbating dyslipidemia. Lipid abnormalities, including hypertriglyceridemia, may be observed during the acute phase of pancreatitis. Malnutrition is associated with various adverse effects on the body's ability to recover and respond to illness, and acute pancreatitis can further exacerbate these issues.

Objective/Purpose

Nevertheless, there is limited scientific evidence of clinical outcomes of PCM in patients with acute pancreatitis & dyslipidemia. Hence, we sought to investigate this population.

Methods

We queried National Inpatient Sample between 2017-2020 for adult patients who were hospitalized with acute pancreatitis & dyslipidemia who had PCM. The primary outcome was inpatient mortality. The secondary outcomes were cardiogenic shock, cardiac arrest, gastrointestinal bleeding (GIB), intubation, length of stay (LOS) and total hospital charge. Multivariable logistic regression analysis was used to estimate clinical outcomes. P-value < 0.05 was significant.

Results

There were 574,269 hospitalizations with acute pancreatitis & dyslipidemia where 31,955 (5.6%) had PCM. PCM and non-PCM cohorts were with mean age of 64 vs. 60 yrs; males 54.4% vs. 56%; Caucasians 66.8% vs. 64.6%; HTN 49% vs. 56%; HF 17.4% vs. 12%; severe sepsis 12.5% vs. 4.2%; PE 3.7% vs. 2.5%; DKA 3.9% vs. 4.9%; AF 16.6% vs. 11.3%; AKI 37.2% vs. 21.8%; acute respiratory failure 17.4% vs. 6.3%; ACS 4.4% vs. 3%; metabolic syndrome 3.7% vs. 9%; history of stroke 1.0% vs. 0.4%, COPD 18.7% vs. 13.3%; alcohol use 19.9% vs. 18.5%, respectively. NAFLD cohort had significantly higher mortality and worse clinical outcomes (Table 1).

Conclusions

PCM group demonstrated significantly higher mortality, worse clinical outcomes and resource utilization, however cardiac arrest and cardiogenic outcomes were not statistically significant. Patients were older, more female population and Caucasians, with more frequent HF, severe sepsis, AF, ACS and AKI. NAFLD is associated with greater risk for cardiovascular events, renal failure, GIB, and ICU care. PCM is an important predictor of adverse outcomes in population. Further research is necessary to describe long-term outcomes.