Outcomes following hospitalization for diabetic ketoacidosis in patients with cardiovascular disease.

Introduction: Diabetic ketoacidosis (DKA) is a serious complication in patients with diabetes. This study compares the outcomes of hospitalized DKA patients with and without cardiovascular disease (CVD). In addition, we assess outcomes between DKA and hyperosmolar hyperglycemic syndrome (HHS) in diabetes patients with CVD, and between those who developed DKA and those who did not. Methods: We employed a population-based, retrospective observational design utilizing data sourced from the National Inpatient Sample database for the years 2016-2022. The primary outcome assessed was in-hospital mortality. In addition, various secondary outcomes were examined, including the incidence of acute respiratory failure, acute kidney failure, septic shock, sepsis, acute neurological failure, pulmonary embolism, deep vein thrombosis, acute liver failure, mechanical ventilation, noninvasive ventilation, and the length of hospital stay (LOS) and total hospital charges. Results: Multivariable regression analysis demonstrated that CVD independently increased mortality and complications, including acute respiratory failure and sepsis, in DKA patients, who also experienced longer LOS and higher medical costs compared to those without CVD. Similar findings were observed when comparing outcomes between DKA and HHS in diabetes patients with CVD, as well as between those who developed DKA and those who did not. Conclusions: This study demonstrates that CVD significantly affects the outcomes of patients admitted for DKA. Moreover, similar negative outcomes were observed when comparing DKA patients with HHS and those who developed DKA versus those who did not. These findings highlight the need for careful management of DKA in patients with CVD to optimize clinical outcomes.