Document Type

Article

Publication Date

1-29-2026

Comments

This article is the author’s final published version in Journal of Arrhythmia, Volume 42, Issue 1, 2026, Article number e70279.

The published version is available at https://doi.org/10.1002/joa3.70279. Copyright © 2026 The Author(s.

 

Abstract

INTRODUCTION: The impact of protein-energy malnutrition (PEM) on patients hospitalized for conventional pacemaker implantation remains poorly understood.

METHODS: We utilized the 2020 U.S. National Inpatient Sample (NIS) database to evaluate the impact of PEM on the in-hospital outcomes of patients who underwent conventional pacemaker implantation. Patients aged 18 and older were identified by ICD-10 CM and PCS codes. Multivariable survey logistic and linear regression analyses were employed to examine in-hospital outcomes, including in-patient mortality, system-based outcomes, and post-procedural complications.

RESULTS: A total of 108 020 patients were identified with 4315 (3.99%) diagnosed with PEM. The mean age of the cohort was 76 years, and 47.5% were female. The overall mortality rate among patients undergoing pacemaker implantation was 1.07%. After adjusting for various patient and hospital confounding factors, PEM was significantly associated with an increased risk of in-hospital mortality (aOR 3.30, 95% CI 2.33-4.88, p < 0.001), prolonged hospital stay (βLOS 7.89, 95% CI 6.88-8.90, p < 0.001), and an increased risk of various complications such as sepsis (aOR 2.56, 95% CI 1.56-4.19, p < 0.001) along with other post-procedural complications including bleeding/anemia (aOR 2.48, 95% CI 1.98-3.10, p < 0.001), pneumothorax (aOR 2.47, 95% CI 1.71-3.58, p < 0.001), and pericardial complications (aOR 1.65, 95% CI 1.14-2.40, p = 0.008).

CONCLUSION: PEM was associated with an increased risk of in-hospital mortality, extended hospital stays, and various post-procedural complications in patients undergoing conventional pacemaker implantation. Hence, prompt identification and effective management of PEM are essential for improving post-procedural outcomes in these patients.

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Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Language

English

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