Malnutrition Severity and Length of Hospital Stay in Adults Hospitalized with Heart Failure: A Retrospective Cohort Study

Abstract

Malnutrition is common in heart failure (HF), but the association between Global Leadership Initiative on Malnutrition (GLIM)-defined severity and hospital length of stay (LOS) remains uncertain. This single-center retrospective cohort study included 277 adults hospitalized with HF between January 2023 and December 2025. Nutritional status was classified as no malnutrition, moderate malnutrition, or severe malnutrition using GLIM criteria. LOS was analyzed using nonparametric comparisons and negative binomial regression. GLIM-defined malnutrition was present in 30.7% of patients: 10.1% had moderate and 20.6% severe malnutrition. Median LOS was 7.0 days in patients without malnutrition, 8.5 days in those with moderate malnutrition, and 8.0 days in those with severe malnutrition (Kruskal–Wallis p=0.025); however, no pairwise comparison remained significant after Bonferroni correction, and no significant ordinal trend was observed (p=0.054). After adjustment for age, sex, HF phenotype, comorbidity, and cumulative electrolyte burden, neither moderate malnutrition (adjusted IRR 1.188, 95% CI 0.964–1.465; p=0.107) nor severe malnutrition (adjusted IRR 1.063, 95% CI 0.905–1.250; p=0.456) was independently associated with LOS. Findings were similar among survivors. GLIM-defined malnutrition was prevalent, but increasing severity was not independently associated with longer hospitalization.