LBODP057 Association Between DKA And Live Abscess: Results From The National Inpatient Sample

Abstract

Abstract Background Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes, it can be the initial sign of unrecognized type 1 or type 2 diabetes; however, it occurs more frequently in patients with established disease, liver abscess is a life-threatening disease with an increasing rate of incidence in patient with uncontrolled diabetes, in this study we examined the association between DKA and liver abscess as formal evidence is limited, Methods This is a retrospective study using the National Inpatient Sample database from 2016 to 2019. A 20% probability sample was collected and subsequently weighted to ensure that the selected population was nationally representative. Using ICD-10-CM codes, all patients diagnosed with liver abscess were identified and considered the study population while excluding patients < 18 years old. Furthermore, baseline demographic data, comorbidities, in-hospital mortality, hospital charges, and hospital length of stay were extracted and compared based on the presence or absence of a concurrent diagnosis of DKA. Statistical analyses were done using t-test and Chi-squared analysis. Finally, multivariate analysis for the mortality odds ratio was calculated after adjusting for possible confounders. Results From a total sample of 140 million patients, 94,600 met the criteria for this analysis and were diagnosed with liver abscess. A 0.96% of this population had a concurrent diagnosis of DKA during the same admission. Patients with liver abscess with DKA were younger than patients without DKA (58 vs. 62.17, p-value 0. 0013). The male gender was predominant in both groups without significant difference between these two groups (58.81% vs. 58.33%, respectively, p-value 0.8962). The white race was dominant in both groups, but more prevalent in non DKA group (62% vs. 44%, respectively, p-value <0. 0001) The mortality rate was significantly higher in the liver abscess with DKA group (7.78% vs. 4.42%, p-value 0. 0289). Patients with DKA incurred higher costs of hospitalization ($213,792 vs. $128,730; P <0. 0001) and longer length of stay (14.5 days vs. 11 days; P 0. 001) than the non-DKA group. The multivariate analysis concluded that DKA carries an odds ratio (OR) of 1.74 (CI 95% 1-3. 03, p-value 0. 049) in patients with liver abscess. In addition to DKA, age greater than 65 years, non-white race and CHF were independently associated with higher mortality. HTN, smoking and obesity were associated with decreased risk of mortality (p-value <0. 001), Discussion: Our retrospective study identified association between DKA and liver abscess. DKA with liver abscess were associated with longer length of stay and higher mortality rate, treatment of the triggering factor is an essential component of the management of DKA, and liver abscess must be considered if sepsis source in DKA patient was unclear. Presentation: No date and time listed