Background: Diabetes and Congestive Heart Failure frequently coexist in the same patients. This aim of the study was to compare the adverse outcome rates of diabetic patient admitted for hyperosmolar hyperglycemic state with concomitant heart failure compared to those without heart failure.
Method: Data were obtained from The National Inpatient Sample (NIS) 2016 and 2017 Database. The NIS was searched for hospitalization for HF as principal diagnosis with and without a secondary diagnosis of diabetes mellitus type 2 with hyperglycemic hyperosmolar state (DM2 with HHS) using International Classification of Diseases, Tenth Revision (ICD-10) codes. Multivariate logistic and linear regression analysis was used accordingly to adjust for possible confounders.
Results: The combined 2016 and 2017 NIS database contained 2,586,684 hospitalizations for adult patients (aged ≥ 18 years) with a principal ICD-10 diagnosis for DM2 with HHS. Among this group, 500 (1.1%) had co-existing HF. Of note, patient admitted for HHS with secondary diagnosis of HF had increased inpatient mortality but did not reach statistical significance (2.0% vs. 0.7%, AOR:1.66, 95% CI 0.41-6.67, p<0.474) compared to those without HF. The adjusted mean LOS in patients with HHS and coexisting HF increased by 2.7 days (7.4 days vs. 3.7 days, 95% CI 1.15-4.24, p=0.001) longer than those without HF. Patient hospitalized with HHS with coexisting HF had higher adjusted mean total hospital charge of $31,287 ($71,589 vs. $32,082, CI 9,677-52,897, p=0.005) compared to those without HF.
Conclusion: Patients admitted for HHS with co-existing heart failure have similar inpatient mortality, however Total hospital charges and LOS were increased in those with HF compared to the patients without HF. Patients with concomitant heart failure and diabetes have diverse pathophysiological mechanism that may contribute to worse outcomes that need to be explored further.
I. R. Asemota: None. H. Shaka: None. E. Edigin: None. M. Almani: None. E. Akuna: None.