Association of Nutrition Intake Adequacy with Clinical Outcomes in Hospitalized Hematopoietic Cell Transplant...

Patients undergoing hematopoietic cell transplantation (HCT) face nutrition-impacting symptoms that compromise oral intake and increase malnutrition risk. The independent relationship between nutrition intake adequacy and clinical outcomes in this population remains incompletely characterized.

To determine whether adequate intake (≥75% of estimated needs) during HCT admission is independently associated with hospital length of stay (LOS), 30-day readmission, and acute graft-versus-host disease (GVHD).

Twelve-month retrospective cohort study using electronic medical records between June 15, 2022 - June 15, 2023. Nutrition intake was averaged across admission from registered dietitian assessments and categorized as adequate (≥75%) or inadequate (<75%).

/Setting: 283 adults (85 autologous, 198 allogeneic) aged ≥18 years admitted to Stanford Health Care for HCT with a length of stay ≥7 days.

Hospital LOS, 30-day readmission, and acute GVHD within 100 days.

Multivariable linear regression for LOS and logistic regression for readmission and GVHD, each adjusted for age, gender, race/ethnicity, and BMI.

In autologous HCT patients, adequate intake was independently associated with shorter LOS (β = -1.91 days, 95% CI -3.33 to -0.48; P = 0.009), and malnutrition at discharge with longer LOS (β = 1.43 days, 95% CI 0.02 to 2.91; P = 0.04). Sensitivity analyses for autologous HCT patients with adequate intake, excluding patients who received enteral or parenteral nutrition support, did not alter these findings (β = -1.51 days, 95% CI -2.99 to -0.03; P = 0.048). In allogeneic patients, no significant associations were found between intake and LOS after adjustment. Intake was not associated with 30-day readmission or acute GVHD in either group.

Among autologous HCT patients, adequate intake was associated with shorter LOS and discharge malnutrition with longer LOS. Optimizing nutritional status may help improve outcomes and reduce hospitalization in this population.