1012-P: Diabetes Is Not Associated with Worse Outcomes in Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Abstract

Background: Diabetes mellitus (DM) is a multisystem metabolic disorder shown to have adverse effects on lung physiology, immune responses, and antimicrobial defenses. However, the impact of DM on the development of poor in-hospital outcomes in patients with Acute COPD exacerbation (AECOPD) is unclear. We aimed to assess this very impact in our study. Methods: A retrospective cohort study was conducted using the Nationwide Inpatient Sample from 2018. About 394,929 hospitalizations had AECOPD as a primary diagnosis and were stratified based on the presence of DM using ICD-10 codes. Multivariate regression analysis was used to adjust for confounders and analyze variables. The selection of covariates was done with a univariate screen and literature review. Results: Out of the 394,929 hospitalized patients with AECOPD, 123,425 patients had DM. In-hospital mortality in AECOPD patients with DM was lower than those without (0.78% vs. 1.17%, p<0.001). Mean length of stay (LOS) and patient costs (PC) were higher in those with DM (4.1 vs. 3.92 days and $9242 vs. $8710 respectively). When adjusted to patient demographics, comorbidities and hospital characteristics, AECOPD patients with DM had a lower risk of mortality (aOR=0.49, p<0.001), myocardial infarction (MI) (aOR=0.58, p<0.001), pulmonary embolism (PE) (aOR=0.71, p=0.011), and stroke (aOR=0.68, p=0.047), as well as a higher risk develop an AKI (aOR=1.07, p=0.024). COPD patients with DM had less LOS by 0.09 days (p=0.007) and PC by $236 (p=0.03) after adjusting for similar covariates. There was no statistical significance in the risk of developing respiratory failure (aOR=0.97, p=0.165) and sepsis (aOR=0.74, p=0.173). Conclusion: DM in AECOPD did not have worse outcomes in terms of in-hospital mortality, LOS, and PC. DM patients had lower risk of MI, PE, and stroke, however, had higher risk of AKI. Further investigation is needed to understand the exact correlation between the paradoxical nature of outcomes in AECOPD in those with DM. Disclosure R. Atluri: None. M. Ramirez: None. H. Shaka: None. M. Murthi: None. C. D. Corpuz: None. S. Velagapudi: None. G. Velazquez: None.