Clinical Outcomes of Patients Hospitalized for Conventional Pacemaker Implantation With Protein-Energy Malnutrition

The impact of protein-energy malnutrition (PEM) on patients hospitalized for conventional pacemaker implantation remains poorly understood.

We utilized the 2020 U.S. National Inpatient Sample (NIS) database to evaluate the impact of PEM on the in-hospital outcomes of patients who underwent conventional pacemaker implantation. Patients aged 18 and older were identified by ICD-10 CM and PCS codes. Multivariable survey logistic and linear regression analyses were employed to examine in-hospital outcomes, including in-patient mortality, system-based outcomes, and post-procedural complications.

A total of 108 020 patients were identified with 4315 (3.99%) diagnosed with PEM. The mean age of the cohort was 76 years, and 47.5% were female. The overall mortality rate among patients undergoing pacemaker implantation was 1.07%. After adjusting for various patient and hospital confounding factors, PEM was significantly associated with an increased risk of in-hospital mortality (aOR 3.30, 95% CI 2.33-4.88, p < 0.001), prolonged hospital stay (β_LOS 7.89, 95% CI 6.88-8.90, p < 0.001), and an increased risk of various complications such as sepsis (aOR 2.56, 95% CI 1.56-4.19, p < 0.001) along with other post-procedural complications including bleeding/anemia (aOR 2.48, 95% CI 1.98-3.10, p < 0.001), pneumothorax (aOR 2.47, 95% CI 1.71-3.58, p < 0.001), and pericardial complications (aOR 1.65, 95% CI 1.14-2.40, p = 0.008).

PEM was associated with an increased risk of in-hospital mortality, extended hospital stays, and various post-procedural complications in patients undergoing conventional pacemaker implantation. Hence, prompt identification and effective management of PEM are essential for improving post-procedural outcomes in these patients.