186-LB: Diabetes Type 2 Is Associated with Higher Mortality in Patients Hospitalized with Diabetic Ketoacidosis: An Analysis of the Nationwide Inpatient Sample Database

Abstract

Introduction: Diabetic ketoacidosis (DKA) is a known complication of patients with diabetes mellitus (DM) type 1, but less common in type 2. The aim of this study was to compare outcomes of patients admitted with DKA in DM types 1 and 2 patients. Methods: This was a population-based, retrospective, observational study using data from the Nationwide Inpatient Sample (NIS) for 2016 and 2017. Hospitalizations of adults >/=18 years old with a principal diagnosis of DKA were obtained using ICD 10 codes. Groups of patients with a secondary diagnosis of DM type 1 and 2 were identified. The primary outcome was inpatient mortality. Secondary outcomes were Length of stay and Total hospital charge. Results: Between 2016-2017, about 245,170 adults had hospitalizations for a principal discharge diagnosis of DKA. Of these hospitalizations, 225495 (92.0%) had DM type 1 compared with 19675 who had DM type 2 (8.0%). Patients with DM type 2 were typically older (mean age 51.0 years vs. 34.4 years) and more likely males. A total of 650 inpatient mortality (0.27%) occurred in patients with DKA. The adjusted odds ratio (aOR) for mortality in patients with DM type 2 compared to DM type 1 was 4.1 (95% CI: 2.740- 6.180, p<0.001) when adjusted for common confounders excluding age. After adjusting for age, the aOR for mortality dropped to 2.0 (95% CI: 1.317 - 3.175 , p<0.001). DM type 2 patients were also found to have an adjusted increase in total hospital charge of $6035 (95% CI: 4420 - 7652, p<0.001) and adjusted increase in length of hospitalization of 0.5 days ((95% CI: 0.3 - 0.6, p<0.001). Conclusions: After adjusting for sex, age, race, hospital location and illness severity, patients with DM type 2 has 2-fold higher odds of inpatient mortality compared to type 1, when admitted for DKA. The odds of mortality are likely higher per duration for which patients have had diabetes. Disclosure H. Shaka: None. E. Edigin: None. S.T. Yap: None. J. Xu: None. T.A. Gomez: None. M. Padilla Sorto: None.