SAT111 Temporal Trends In Patients Hospitalized With Diabetic Ketoacidosis And Associated Outcomes: Insights From The National Inpatient Sample
Authors: Chaudhary Malvika , Jung Jenny , Farooq Awais , Heersink Juanita 
Published: October 2023

Abstract
Disclosure: M. Chaudhary: None. J. Jung: None. A. Farooq: None. J. Heersink: None.
Background: Patients hospitalized with Diabetic Ketoacidosis (DKA) exhibit increased risk for mortality and morbidity. Previous work has illustrated concerns for DKA incidence increasing further highlighting the burden it may present to the US healthcare system. We aim to demonstrate the current baseline characteristics in hospitalized DKA patients and to identify and stratify risk factors that lend to deleterious patient outcomes. Methods: Patient data was collected for years 2011-2018 from the National Inpatient Sample (NIS) using International Classification of Disease-Revision Codes (ICD-9 and 10). We selected patients hospitalized with a principal diagnosis of DKA with ICD Coding. Multivariate logistic regression was used to determine adjusted odds ratios (AOR). Mann-Whitney U testing was utilized to calculate mean differences in age, length of stay (LOS), and total hospital charges. Additionally temporal trends were tabulated with linear regression models to determine any significant changes over time in select risk factors and outcomes. Results: A total of 313,608 patients were included in our data analysis. Self-pay patients had a 28.3% (CI 1.020-1.613, P&lt;0.05) increase in mortality rate compared to Medicare payers. Asians had 60.5% (CI 1.039-2.479, P&lt;0.05) increased risk of mortality compared to Caucasians. Increased mortality rates were seen in patients with following comorbid conditions: ESRD (149%) (CI 1.986-3.140, P&lt;0.05), Obesity (70.5%) (CI 1.425-2.040, P&lt;0.05)and CAD (25%) (CI 1.057-1.478, P&lt;0.05). Females with DKA had a decreased risk of mortality by 21%(Cl 0.697-0.894, P&lt;0.05). Patients in the highest quartile median zip code income had a decreased mortality risk of 18.7% compared to patients in the 1st quartile (add the P value). There was a 25.6% (CI 1.069-1.505, P&lt;0.05) decreased mortality rate in hospitals with large bed size and a 30.8% decreased mortality rate in urban located teaching hospitals (CI 1.062-1.612, P&lt;0.05). We observed decreases in LOS and over time P&lt;0.05 and increase in Hospital Charges over time P&lt;0.05. Conclusion: We observed correlation between socio-economic and demographic factors and mortality outcomes in patients hospitalized with DKA. Based on our analysis, we found patients with ESRD, Obesity, and CAD to exhibit the highest mortality risk. Decreased LOS over time may exhibit incremental improvements in quality of care of patients hospitalized with DKA and would beget further analysis in comparison with available longitudinal studies with more granular data. Increased total charges may represent an increasing patient complexity and this warrants further investigation. Further research in community-based hospital settings is needed and it is important to note that targeted prevention measures, such as diabetes education, may help prevent life-threatening diabetic complications such as DKA from arising.
Presentation: Saturday, June 17, 2023