PW25 - DELAYED MEAL PROVISION INCREASES RISK OF HOSPITAL-ASSOCIATED DISABILITY, COMPLICATIONS, AND PROLONGED LENGTH OF STAY IN OLDER PATIENTS WITH HEART FAILURE: A NATIONWIDE STUDY
PW25
DELAYED MEAL PROVISION INCREASES RISK OF HOSPITAL-ASSOCIATED DISABILITY, COMPLICATIONS, AND PROLONGED LENGTH OF STAY IN OLDER PATIENTS WITH HEART FAILURE: A NATIONWIDE STUDY
T. Inoue1,*, K. Maeda2,3, Y. Ishida4, F. Kawase5, A. Saito6, A. Nagano7, J. Ueshima8, S. Miyahara3, Y. Saino9, H. Murata10, K. Murotani11,12
1Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, 2Nutrition Therapy Support Center, Aichi Medical University Hospital, 3Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, 4Department of Nutrition, Aichi Medical University Hospital, 5Department of Nutrition, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Aichi, 6Department of Nutrition, Yoshida Hospital, Niigata, 7Clinical Nurse Consultant Ca-resso, Hyogo, 8Department of Nutritional Service, NTT Medical Center Tokyo, Tokyo, 9Department of Clinical Nutrition, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Chiba, 10Department of Physical Therapy, Faculty of Health Science, Kyorin University, Tokyo, 11School of Medical Technology, 12Biostatistics Center, Kurume University, Fukuoka, Japan
Rationale: Delayed initiation of meal provision may contribute to hospital-associated disability (HAD), a critical yet overlooked outcome affecting older heart failure (HF) patients. This study evaluated the impact of delayed oral feeding on HAD, complications, and hospital length of stay (LOS) in older hospitalized patients with HF.
Methods: This retrospective cohort study utilized nationwide Diagnosis Procedure Combination data from Japan, including patients aged 65–99 years hospitalized for HF (ICD-10 codes: I50.0, I50.1, I50.9) classified as NYHA class II or higher. The exposure was defined as no meal provision within the first three hospital days. The primary outcome was HAD, defined as a decrease in Barthel Index from admission to discharge. Secondary outcomes included hospital complications and LOS. Inverse probability of treatment weighting (IPTW) was applied to control confounders, with balance assessed via standardized mean differences (SMD). Outcomes were compared between groups using chi-square, t-tests, and logistic or multiple linear regression analyses based on the IPTW-weighted data.
Results: The final analytic cohort comprised 64,330 patients. Among these, delayed meal initiation was observed in 4.2% before IPTW adjustment. After IPTW adjustment, baseline characteristics were well-balanced (all SMD <0.1). Delayed meal initiation significantly increased HAD (12.4% vs. 21.8%, p <0.001), complications (51.5% vs. 63.8%, p <0.001), and prolonged hospital LOS (mean days: 22.1 vs. 30.4, p <0.001). These findings remained robust after logistic and multiple linear regression analyses (HAD: OR 1.96, 95% CI 1.70–2.27; complications: OR 1.66, 95% CI 1.49–1.86; length of stay: adjusted mean difference 8.3 days, 95% CI 7.1–9.5).
Conclusion: Delayed meal initiation significantly increases HAD, complications, and length of stay in older HF patients. Early nutritional intervention is recommended.
Disclosure of Interest: None declared