1537-P: Impact of Obesity on Outcomes of Diabetic Ketoacidosis: A Nationwide Analysis

Abstract

Background: Obesity is associated with better outcomes in diseases like myocardial infarction and heart failure, a phenomenon known as obesity paradox. However, the effect of obesity on healthcare outcomes after admission for diabetic ketoacidosis (DKA) has not been well characterized. Objective: We aimed to explore the impact of obesity and morbid obesity on outcomes in patients hospitalized with DKA. Methods: The National Inpatient Sample database for the year 2016 was queried. All admissions with a principal diagnosis of DKA were identified. Obesity (BMI 30-40 kg/m2) and morbid obesity (BMI >40 Kg/m2) were identified using their appropriate validated ICD-10 codes. Statistical analysis was performed using STATA. The Odds ratio adjusted for age and gender was calculated for obesity and morbid obesity respectively. Results: The study included 210,455 hospitalizations with a principal diagnosis of DKA. Out of these, 19,341 (9.19%) were obese and 7,640 (3.63%) were morbidly obese. Obese DKA patients had a longer length of stay (3.79 vs. 3.14 days, p<0.001) and higher hospitalization costs ($34,643 vs. $28,976; p<0.001) compared to their non-obese counterparts. There was no significant difference in the adjusted in-hospital mortality rates in DKA patients with and without obesity (0.52% vs. 0.38%, adjusted odds ratio 1.25, p=0.34). However, DKA patients who were morbidly obese had increased mortality compared to those without morbid obesity (0.72% vs. 0.38%, adjusted odds ratio 1.85, p=0.04). Conclusion: DKA patients with obesity have a longer length of stay and higher hospitalization costs, but similar inpatient mortality rates compared to those without obesity. Morbid obesity is associated with increased mortality in DKA patients. Disclosure M. Mudgal: None. A. Goel: None.

Severe Prolonged SGLT2i-induced Euglycemic Diabetic Ketoacidosis Refractory to Standard Therapy and Dialysis: Case Report and Literature Review

“…Elsheikh et al, 9 reported increased mortality associated with morbid obesity in patients with DKA with an adjusted odds ratio (AOR) of 1.37 (95% CI: 1.18–1.61, but not obesity with lower BMI in the range 30–40. 9 Similarly, Mudgal et al, 10 large-scale study found that morbidly obese DKA patients had higher mortality than those without morbid obesity (0.72% vs. 0.38%; AOR = 1.85; p = 0.040). The study also reported that obese DKA patients had longer hospital stays (3.79 vs. 3.14 days, p < 0.001) than their non-obese counterparts.…”