Comparing Outcomes of Diabetic Ketoacidosis Hospitalizations in Patients With Diastolic Heart Failure: A Retrospective Propensity Matched Analysis of the Nationwide Inpatient Sample

Link to article at PubMed

Diabetes Metab Res Rev. 2021 Jan 13. doi: 10.1002/dmrr.3435. Online ahead of print.


INTRODUCTION: Diabetic ketoacidosis (DKA) is a known complication of patients with diabetes mellitus (DM). The aim of this study was to compare the outcomes of patients admitted with a diagnosis of DKA with, and without, diastolic heart failure.

METHODS: This was a population-based, retrospective, observational study using data from the National Inpatient Sample (NIS) database for the years 2016 and 2017. The primary outcome was in-hospital mortality. Secondary outcomes were rates of sepsis, non-ST elevation myocardial infarctions (NSTEMI), (acute kidney failure (AKF), acute respiratory failure (ARF), deep vein thrombosis (DVT), pulmonary embolism (PE), mean length of hospital stay (LOS), and total hospital charges (THC).

RESULTS: There was no statistically significant difference for the adjusted odds for in-hospital mortality between patients with and without diastolic heart failure (aOR: 0.55, 95% CI 0.28 - 1.08, p=0.081). Patients with DKA and diastolic heart failure had increased odds of developing an NSTEMI (aOR: 1.31, 95% CI: 1.01 - 1.70, p=0.045) or ARF (aOR: 1.82, 95% CI: 1.38 - 2.40, p<0.001) during the same admission compared to patients without diastolic heart failure. Patients with DKA and diastolic heart failure also had an increased mean THC (6500 CI: 1900 - 11200, p=0.0006) in US dollars and increased LOS (0.7, 95% CI: 0.2 - 1.3, p=0.011) in days when compared to patients without diastolic heart failure.

CONCLUSIONS: Patients with DKA showed no statistically significant difference in mortality if they did or did not have a secondary diagnosis of diastolic heart failure within the same admission. This article is protected by copyright. All rights reserved.

PMID:33440066 | DOI:10.1002/dmrr.3435

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