Not All Ventricular Arrhytmias Require A Reduction In LVAD Speed.
HFSA ePoster Library. Garcia Galan D. 09/10/21; 343567; 325
Daphne Garcia Galan
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Abstract
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Introduction: Patients admitted with Diabetic ketoacidosis (DKA) are often volume depleted and require large volumes of intravenous fluids for resuscitation. Large volume resuscitation can have major impacts on the mortality, length of hospital stay and cost in the Heart failure population with reduced ejection fraction. Currently, there are no guidelines regarding volume repletion in patients admitted with DKA and a concomitant history of heart failure with reduced ejection fraction (DKAHF). The aim of this study is to determine in-hospital mortality, length of stay (LOS), total cost of hospitalization, and intubation rates in patients admitted with DKAHF.
Methods: We performed a retrospective study by utilizing the 2016 National inpatient sample, a large publicly available database which comprises data on 20% of hospital discharges for that year in over 1000 hospitals in the United States. We included patients aged 18 or older who were admitted to the hospital with a principal diagnosis of DKA, and then further subdivided this group to those with and without a secondary diagnosis of heart failure with reduced ejection fraction (HF) as comparison groups. ICD 10 CM codes were used to extract the diagnosis data. A multivariate logistic regression model was used to analyze categorical variables and a linear regression was used for the analysis of continuous variables.
Results: A total of 184,085 patients included in the study had DKA, of which 2,200 had HF. The DKAHF group has a mean age of 55.9 (SD 15.4), 59% were Caucasian, and 43.8% were female. Overall, 5.9% were intubated in the DKAHF group, compared to 1.4% in the control group, and the adjusted odds ratio for intubation was 2.16 (CI 1.3-3.4, p = 0.001). The mean length of stay was 6.03, nearly double the control group, and the mean total charges were $54,734, significantly above the control. While the mortality rate was 1.59%, again significantly above the control group, the adjusted mortality rate was not statistically significant, with an Odds Ratio of 1.11 (CI 0.45 - 2.7, p = 0.81).
Conclusion: Hospitalized patients with DKA and heart failure with reduced ejection fraction had a greater length of hospital stay, total cost of hospitalization, and intubation rates, although no significant increase in mortality. If protocols became available to guide volume resuscitation in DKA patients with underlying heart failure, it may allow for a reduction in duration of hospitalization, associated cost and intubation rates. However, further studies are required to provide some guidance on this commonly encountered scenario.
Methods: We performed a retrospective study by utilizing the 2016 National inpatient sample, a large publicly available database which comprises data on 20% of hospital discharges for that year in over 1000 hospitals in the United States. We included patients aged 18 or older who were admitted to the hospital with a principal diagnosis of DKA, and then further subdivided this group to those with and without a secondary diagnosis of heart failure with reduced ejection fraction (HF) as comparison groups. ICD 10 CM codes were used to extract the diagnosis data. A multivariate logistic regression model was used to analyze categorical variables and a linear regression was used for the analysis of continuous variables.
Results: A total of 184,085 patients included in the study had DKA, of which 2,200 had HF. The DKAHF group has a mean age of 55.9 (SD 15.4), 59% were Caucasian, and 43.8% were female. Overall, 5.9% were intubated in the DKAHF group, compared to 1.4% in the control group, and the adjusted odds ratio for intubation was 2.16 (CI 1.3-3.4, p = 0.001). The mean length of stay was 6.03, nearly double the control group, and the mean total charges were $54,734, significantly above the control. While the mortality rate was 1.59%, again significantly above the control group, the adjusted mortality rate was not statistically significant, with an Odds Ratio of 1.11 (CI 0.45 - 2.7, p = 0.81).
Conclusion: Hospitalized patients with DKA and heart failure with reduced ejection fraction had a greater length of hospital stay, total cost of hospitalization, and intubation rates, although no significant increase in mortality. If protocols became available to guide volume resuscitation in DKA patients with underlying heart failure, it may allow for a reduction in duration of hospitalization, associated cost and intubation rates. However, further studies are required to provide some guidance on this commonly encountered scenario.
Introduction: Patients admitted with Diabetic ketoacidosis (DKA) are often volume depleted and require large volumes of intravenous fluids for resuscitation. Large volume resuscitation can have major impacts on the mortality, length of hospital stay and cost in the Heart failure population with reduced ejection fraction. Currently, there are no guidelines regarding volume repletion in patients admitted with DKA and a concomitant history of heart failure with reduced ejection fraction (DKAHF). The aim of this study is to determine in-hospital mortality, length of stay (LOS), total cost of hospitalization, and intubation rates in patients admitted with DKAHF.
Methods: We performed a retrospective study by utilizing the 2016 National inpatient sample, a large publicly available database which comprises data on 20% of hospital discharges for that year in over 1000 hospitals in the United States. We included patients aged 18 or older who were admitted to the hospital with a principal diagnosis of DKA, and then further subdivided this group to those with and without a secondary diagnosis of heart failure with reduced ejection fraction (HF) as comparison groups. ICD 10 CM codes were used to extract the diagnosis data. A multivariate logistic regression model was used to analyze categorical variables and a linear regression was used for the analysis of continuous variables.
Results: A total of 184,085 patients included in the study had DKA, of which 2,200 had HF. The DKAHF group has a mean age of 55.9 (SD 15.4), 59% were Caucasian, and 43.8% were female. Overall, 5.9% were intubated in the DKAHF group, compared to 1.4% in the control group, and the adjusted odds ratio for intubation was 2.16 (CI 1.3-3.4, p = 0.001). The mean length of stay was 6.03, nearly double the control group, and the mean total charges were $54,734, significantly above the control. While the mortality rate was 1.59%, again significantly above the control group, the adjusted mortality rate was not statistically significant, with an Odds Ratio of 1.11 (CI 0.45 - 2.7, p = 0.81).
Conclusion: Hospitalized patients with DKA and heart failure with reduced ejection fraction had a greater length of hospital stay, total cost of hospitalization, and intubation rates, although no significant increase in mortality. If protocols became available to guide volume resuscitation in DKA patients with underlying heart failure, it may allow for a reduction in duration of hospitalization, associated cost and intubation rates. However, further studies are required to provide some guidance on this commonly encountered scenario.
Methods: We performed a retrospective study by utilizing the 2016 National inpatient sample, a large publicly available database which comprises data on 20% of hospital discharges for that year in over 1000 hospitals in the United States. We included patients aged 18 or older who were admitted to the hospital with a principal diagnosis of DKA, and then further subdivided this group to those with and without a secondary diagnosis of heart failure with reduced ejection fraction (HF) as comparison groups. ICD 10 CM codes were used to extract the diagnosis data. A multivariate logistic regression model was used to analyze categorical variables and a linear regression was used for the analysis of continuous variables.
Results: A total of 184,085 patients included in the study had DKA, of which 2,200 had HF. The DKAHF group has a mean age of 55.9 (SD 15.4), 59% were Caucasian, and 43.8% were female. Overall, 5.9% were intubated in the DKAHF group, compared to 1.4% in the control group, and the adjusted odds ratio for intubation was 2.16 (CI 1.3-3.4, p = 0.001). The mean length of stay was 6.03, nearly double the control group, and the mean total charges were $54,734, significantly above the control. While the mortality rate was 1.59%, again significantly above the control group, the adjusted mortality rate was not statistically significant, with an Odds Ratio of 1.11 (CI 0.45 - 2.7, p = 0.81).
Conclusion: Hospitalized patients with DKA and heart failure with reduced ejection fraction had a greater length of hospital stay, total cost of hospitalization, and intubation rates, although no significant increase in mortality. If protocols became available to guide volume resuscitation in DKA patients with underlying heart failure, it may allow for a reduction in duration of hospitalization, associated cost and intubation rates. However, further studies are required to provide some guidance on this commonly encountered scenario.
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