Association of protein intake during hospitalization with readmission in older adult patients with heart failure at risk of malnutrition

Abstract

Background: The influence of protein intake during hospitalization on postdischarge readmission in patients with heart failure (HF) is still unclear. This study aimed to investigate the relationship between protein intake and readmission in older adult patients with HF at risk of malnutrition.

Methods: This retrospective observational study was conducted at a single acute care hospital. Patients were diagnosed with HF between April 2017 and March 2019, aged ≥65 years, and had a body mass index <35 and Geriatric Nutritional Risk Index <92 were included in the analysis. The primary outcome was HF-related readmission within 1 year after discharge. The Cox proportional hazards model was used to determine whether protein intake was an independent predictor of readmission within 1 year.

Results: Ultimately, 165 patients were included in the analysis: 105 patients did not require readmission, and 60 required readmission because of HF-related events. Multivariate analysis showed that protein intake <1.2 g/kg/day was an independent contributor to readmission in either model (model 1: hazard ratio [HR] = 2.07 [95% CI, 1.07-4.01], P = 0.030; model 2: HR = 2.24 [95% CI, 1.15-4.37], P = 0.018; model 3: HR = 2.70 [95% CI, 1.23-5.94], P = 0.013; and model 4: HR = 2.88 [95% CI, 1.28-6.51], P = 0.011).

Conclusion: Low protein intake during hospitalization in older adult patients with HF at risk of malnutrition may increase the rate of readmission within 1 year after discharge. Nutrition intervention should be provided to these patients early during their hospitalization to ensure sufficient protein intake to maintain and improve their nutrition status and activity level.

Keywords: heart failure; hospitalization; malnutrition; older adults; patient readmission; protein.