Endocrine Abstracts

Background: Diabetes mellitus (DM) is a critical global health crisis, characterised by rising prevalence and severe complications that strain healthcare systems. Diabetic-ketoacidosis (DKA) is the most severe complication of DM. Anaemia can worsen tissue hypoxia in DKA, trigger inflammatory pathways, disrupt fluid-electrolyte balance, and alter pharmacokinetics of medications. While the role of anemia in diabetes has been studied, its impact on DKA hospitalisations, a common reason for admissions in DM, remains largely unexplored. This study analyses the effects of anaemia on DKA hospitalisation outcomes.

Methods: The National Inpatient Sample database (2016-2020) was analysed using ICD-10 codes to identify adults hospitalised with DKA, with the cohorts stratified by anaemia prevalence. Categorical variables were compared using chi-square test, while continuous variables were assessed with t-test, considering p-value < 0.05 significant. Multivariate regression analysis evaluated the impact of anaemia on DKA hospitalisation outcomes, adjusting for relevant confounders and hospital characteristics.

Results: A total of 2,068,114 DKA hospitalisations were identified, with 21.85% having anaemia. DKA patients with anaemia were older compared to those without (50.60 vs 43.83 years). Among anaemic patients, 55.02% were females. DKA hospitalisations with anaemia had worse outcomes (Table) and resulted in increased resource utilisation, marked by a longer stay of 3.89 days (7.85 vs 3.96) and higher hospitalisation costs by $52,003 (95,828$ vs 43, 825$).

Conclusion: This study underscores the significant impact of anaemia on DKA hospitalisations, highlighting the need to address anaemia to improve clinical outcomes and optimise resource utilisation.