CONUT-Defined Nutritional Risk and Length of Hospital Stay in Patients with Heart Failure: A Retrospective Cohort Study

Abstract

Heart failure (HF) is frequently accompanied by nutritional impairment, yet the relationship between nutrition-related risk and hospital length of stay (LOS) remains uncertain. This retrospective cohort study evaluated 103 adults hospitalized with HF at Dr. Wahidin Sudirohusodo General Hospital, Makassar, Indonesia, between January 2023 and December 2025. Nutritional risk was assessed using the Controlling Nutritional Status (CONUT) score and categorized as normal, mild, moderate, or severe. The primary outcome was LOS in days; prolonged LOS (>14 days) and in-hospital mortality were secondary outcomes. Negative binomial regression was used for LOS and binary logistic regression for secondary outcomes, adjusting for age, sex, body mass index, left ventricular ejection fraction, and comorbidity burden. CONUT status was normal in 7.8%, mild in 30.1%, moderate in 49.5%, and severe in 12.6%. Median LOS was 13.5, 11, 13, and 14 days across these categories, respectively (p=0.890). CONUT was not associated with LOS in crude (overall p=0.844) or adjusted analyses (overall p=0.932). Adjusted mean ratios were 1.063 for mild, 0.994 for moderate, and 1.089 for severe CONUT status compared with normal status. No significant associations were observed with prolonged LOS or in-hospital mortality. Continuous-score sensitivity analysis was concordant (aMR 0.987, 95% CI 0.949–1.026; p=0.514). CONUT-defined nutritional risk was not independently associated with hospitalization duration in this cohort.