PD959 - ASSOCIATION BETWEEN TIMING OF AMINO ACID INFUSION AND FUNCTIONAL RECOVERY IN OLDER PATIENTS WITH HEART FAILURE RECEIVING ORAL INTAKE: A NATIONWIDE STUDY IN JAPAN

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PD959

ASSOCIATION BETWEEN TIMING OF AMINO ACID INFUSION AND FUNCTIONAL RECOVERY IN OLDER PATIENTS WITH HEART FAILURE RECEIVING ORAL INTAKE: A NATIONWIDE STUDY IN JAPAN

T. Inoue1,*, Y. Ishida2, A. Saito1,3, K. Murotani4, K. Maeda5,6

1Graduate School of Health and Welfare, Niigata University of Health and Welfare, Niigata, 2Nutrition, Aichi Medical University Hospital, Nagakute, 3Nutrition, Yoshida Hospital, Niigata, 4Kurume University, Kurume, 5Nutrition Therapy Support Center, Aichi Medical University Hospital, Nagakute, 6Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu, Japan

 

Rationale: Amino acid infusion is commonly used in hospitalized patients with heart failure; however, the clinical importance of its timing remains unclear. This study aimed to examine the association between timing of amino acid infusion and functional recovery using real-world data.

Methods: We conducted a retrospective observational study using a nationwide administrative database. Patients aged 65–99 years hospitalized for heart failure with NYHA class ≥III were included. Additional criteria were initiation of oral intake on hospital day 2, no enteral nutrition during days 2–5, and intravenous fluids ≥500 mL on at least one of days 2–5. Timing of amino acid infusion was categorized as early (day 2), middle (day 3), and late (days 4–5). Functional recovery was assessed using change in the Barthel Index (ΔBI) from admission to discharge. Inverse probability of treatment weighting (IPTW) was applied to adjust for baseline differences. Analyses were limited to patients with baseline BI <90.

Results: A total of 19,301 patients were included, of whom 2,634 (13.6%) received amino acid infusion. After IPTW, baseline characteristics were well balanced (all standardized mean differences <0.1). Mean age was 85.7 years, and 40% were male. Delayed initiation was significantly associated with reduced functional recovery compared with early initiation (β = −13.6, p = 0.021), whereas no significant difference was observed for middle initiation. Stratified analyses showed a stronger association in patients with moderate disability (BI 21–60; β = −27.8, p = 0.020), but not in those with higher baseline BI.

Conclusion: Early initiation of amino acid infusion may be associated with better functional recovery, suggesting that timing is clinically important.



 

Disclosure of Interest: None declared