Objective: Limited data are available on continuation of outpatient sodium glucose co-transporter-2 inhibitors (SGLT2i) during hospitalization.
Design: Nationwide study of admissions of veterans with diabetes where SGLT2i was continued (CONT) in the hospital (N=5,943) compared to those where it was discontinued (DC) (N=30,634). Primary outcome was in-hospital mortality. Secondary outcomes were acute kidney injury (AKI), intensive care unit (ICU) transfer and length of stay (LOS). Propensity-weighted Poisson regression analyses adjusted for age, sex, race, BMI, Elixhauser comorbidity index were performed.
Results: Mean (SE) age was 67.2 (0.1) and 67.5 (0.1) years (p=0.03), male 97.0% and 96.6% (p=0.1), white 71.3% and 72.1%, black 20.8% and 20.5% (p=0.52) in CONT vs. DC groups, respectively. After covariate adjustment, CONT had 44% lower mortality rate (IRR 0.56, 95% CI 0.43, 0.74, p=0.0001), no difference in AKI (IRR 0.95, 95% CI 0.89, 1.01, p=0.12), and 41% lower rate of ICU transfer (IRR 0.59, 95% CI 0.53, 0.65, p<0.0001). LOS was 4.5 vs. 4.9 days (IRR 0.93, 95% CI 0.91, 0.95, p<0.0001), in the CONT vs. DC. Similar trends observed after adjusting for additional models.
Conclusion: Continued SGLT2i during hospitalization was associated with lower mortality and ICU transfer, no increased AKI, and shorter LOS.
L.G.Singh: None. S.Ntelis: None. T.Siddiqui: None. S.L.Seliger: Other Relationship; Tricida, Inc., Research Support; Reata Pharmaceuticals, Inc., Palladio Bioscences, Roche Diagnostics. J.D.Sorkin: None. I.Spanakis: Research Support; Dexcom, Inc.
