Comparing outcomes of diabetic ketoacidosis hospitalisations in patients with diastolic heart failure: A retrospective propensity matched analysis of the nationwide inpatient sample.

INTRODUCTION

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

METHODS

This was a population-based, retrospective, observational study using data from the National Inpatient Sample 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, acute respiratory failure (ARF), deep vein thrombosis, pulmonary embolism, 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 DHF (adjusted odds ratio [aOR]: 0.55, 95% confidence interval [CI] 0.28-1.08, p = 0.081). Patients with DKA and DHF 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 DHF. Patients with DKA and DHF also had an increased mean THC (6500 CI: 1900-11,200, 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 DHF.

CONCLUSIONS

Patients with DKA showed no statistically significant difference in mortality if they did or did not have a secondary diagnosis of DHF within the same admission.