Combination of low muscle strength and malnutrition is associated with longer length of hospital stay among older patients with heart failure

Abstract

Background: Muscle strength and nutritional status are associated with length of hospital stay (LOHS) in older patients with heart failure (HF).

Objectives: The purpose of the study was to examine the association of the combination of muscle strength and nutritional status on LOHS in older patients with HF.

Methods: This retrospective cohort study included 414 older inpatients with HF (men, 57.2%; median age, 81 years; interquartile range, 75-86 years). Patients were categorized into four groups according to their muscle strength and nutritional status: group 1, high muscle strength and normal nutritional status; group 2, low muscle strength and normal nutritional status; group 3, high muscle strength and malnutrition; and group 4, low muscle strength and malnutrition. The outcome variable was the LOHS, and an LOHS of >16 days was defined as long LOHS.

Results: Multivariate logistic regression analysis adjusted for baseline characteristics (reference, group 1) showed that group 4 was associated with a more significant risk of long LOHS (odds ratio [OR], 3.54 [95% confidence interval, 1.85-6.78]). In the subgroup analysis, this relationship was maintained for the first admission HF group (OR, 4.65 [2.07-10.45]) but not for the HF readmission group (OR, 2.80 [0.72-10.90]).

Conclusions: Our results suggest that the long LOHS for older patients with HF at first admission was associated with a combination of low muscle strength and malnutrition but not by either factor individually.

Keywords: Heart failure; Length of hospital stay; Muscle strength; Nutrition.