Abstract #1407267: In-hospital Outcomes of Myxedema Coma in Teaching Vs Non-teaching Hospitals

Abstract

Many studies have analyzed current data on outcomes at teaching vs non-teaching hospitals, and the results have been found to be dissimilar in certain hospitalizations in the United States. this study set out to examine the differences in healthcare outcomes between teaching and non-teaching hospitals in patients who were admitted for myxedema coma using a nationally representative sample. We reviewed data from the National Inpatient Sample (NIS) of patients between 2016-2019. Using ICD-10 diagnosis codes, we identified patients who were admitted due to myxedema coma within the study period. We further categorized our study population into 2 groups based on teaching vs non-teaching status. Multivariate analysis was done to investigate the in-hospital outcomes between both groups and adjust for confounders. During the study period, 3,839 myxedema coma admissions were identified. Teaching hospitals received 70.7% (2,715) of these admissions, while non-teaching hospitals received 29.3% (1,124). The mean age of the cohort was 66 years, 70% were females and 69% were white. The mean length of stay (LOS) was 9.4 days and the average total hospital charge was 89,068 $. There was no significant difference in in-hospital mortality in both groups (OR 1.23, 95% CI 0.66 -2.27, p=0.507). The teaching hospital group had increased odds of acute respiratory failure (OR 1.6, 95% CI 1.07 – 2.4, p = 0.021), acute kidney injury (OR 1.48, 95% CI 1.04 – 2.1, p = 0.028), and bradycardia (OR 1.67, 95% CI 1.06 – 2.6, p = 0.025). No significant risk difference between the two groups in terms of hyponatremia (OR 0.91, 95% CI 0.6 – 1.36, p= 0.66), pericardial effusion (OR 0.87, 95% CI 0.41 – 1.8, p= 0.719) or sepsis (OR 1.38, 95% CI 0.69 – 2.7, p= 0.353). Hospital teaching status was associated with an increased mean LOS (10 vs 7.9 days, p=0.002) and mean total hospital charges (93,122 vs 79,336 $, p=0.035). The study clearly showed that patients admitted with myxedema coma in teaching hospitals have an increased risk of in-hospital outcomes including acute respiratory failure, acute kidney injury, and bradycardia compared to non-teaching hospitals. Teaching hospital status was not associated with increased in-hospital mortality in myxedema coma admissions.