6607 Impact of Day of Admission on Hypoglycemia

Abstract

Abstract Disclosure: S. Neupane: None. B. Neupane: None. S. Karki: None. A. Bhandari: None. M. Quartuccio: None. Introduction: The day of admission, whether on a weekend or a weekday, plays a pivotal role in hospital mortality and outcomes, with studies indicating increased adjusted hospital mortality rates across various diseases. Hypoglycemia, a common complication seen in hospitalized patients, has not been extensively studied concerning its association with weekend admissions. Objective of the study: This research aims to investigate and compare the impact of weekend versus weekday admissions on mortality rates, length of hospital stays, total hospitalization costs, and various other outcomes related to hypoglycemia. Methods: Utilizing the National Inpatient Sample (NIS) for the years 2017 through 2020, we conducted a retrospective cohort study of adult patients (age >18) diagnosed with hypoglycemia. Disease and outcome codes were determined through the International Classification of Diseases (ICD-10), and data analysis was performed using STATA. Multivariate regression analysis adjusted for potential variables while the student t-test and Fisher exact test were employed for comparing continuous and proportional variables, respectively. The primary outcome of the study was mortality, with secondary outcomes encompassing length of stay (LOS), total hospitalization costs, acute coronary syndrome (ACS), septic shock, pulmonary edema, acute respiratory failure (ARF), mechanical ventilation, acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), and cerebrovascular accidents (CVA). Results: Among 804,164 hypoglycemia patients, 199,474 were admitted on weekends. Significant findings included higher mortality rates (adjusted odds ratio (aOR) = 1.08, 10.58% vs. 9.81%, p < 0.001), reduced mean LOS (adjusted mean difference = -0.32, 6.94 days vs. 7.3 days, p < 0.001), and lower total hospitalization charges (adjusted mean difference= -$3713, $81,026 vs. $84,471, p < 0.001) in weekend admissions. Additionally, weekend admissions exhibited increased rates of septic shock, ARF, mechanical ventilation, and AKI. There were no differences in the rates of ACS, pulmonary edema, ARDS, and CVA. Trends indicated rising mortality rates, longer hospital stays, and increased costs for weekend and weekday admissions over the three-year study period. Conclusion: Weekend admissions for hypoglycemia are associated with unfavorable outcomes, including higher mortality rates, septic shock, mechanical ventilation rates, AKI, and ARF compared to weekday admissions. However, weekend admissions showed a decrease in the mean length of hospital stay and total hospitalization charges. Ongoing analysis of the underlying causes driving these outcomes is imperative for informing state and federal planning strategies aimed at mitigating these issues. Presentation: 6/1/2024