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The Effect of Atrial Fibrillation on Mortality Outcomes in Patients Admitted With Diabetic Ketoacidosis

Ajay Mishra1, Umabalan Thirupathy2, Anil Jha1

  • 1Department of Cardiovascular Medicine, Saint Vincent Hospital, Worcester, MA, USA.

Journal of Community Hospital Internal Medicine Perspectives
|May 1, 2025
PubMed

Insights

Atrial fibrillation (AFib) increases mortality risk for patients hospitalized with diabetic ketoacidosis (DKA). While AFib patients had shorter hospital stays, their overall hospitalization costs were higher, indicating a complex association.

Area of Science:

  • Cardiology
  • Endocrinology
  • Health Services Research

Background:

  • Diabetic ketoacidosis (DKA) is a severe complication of diabetes.
  • Atrial fibrillation (AFib) is a common cardiac arrhythmia with significant health implications.
  • The combined impact of DKA and AFib on patient outcomes requires further investigation.

Purpose of the Study:

  • To determine the effect of atrial fibrillation (AFib) on mortality in patients hospitalized with diabetic ketoacidosis (DKA).
  • To analyze secondary outcomes including length of stay (LOS) and total hospitalization charges in DKA patients with and without AFib.

Main Methods:

  • Retrospective analysis of the National Inpatient Sample Database (2018-2019).
  • Identification of patients with DKA using ICD-10 CM codes.
  • Multivariate logistic regression to assess the association between AFib and mortality, LOS, and hospitalization costs.

Main Results:

  • A total of 447,570 DKA patients were analyzed; 12,770 had concurrent AFib.
  • Patients with DKA and AFib exhibited increased mortality (OR = 1.4, p = 0.048).
  • DKA patients with AFib had a lower LOS (3.1 vs. 5.2 days) but higher hospitalization charges (USD 53,576 vs. USD 32,533).

Conclusions:

  • Atrial fibrillation is associated with higher mortality in patients hospitalized for DKA.
  • Despite shorter lengths of stay, DKA patients with AFib incur greater healthcare costs.
  • Further research is warranted to elucidate the mechanisms underlying this association and inform clinical management.

Keywords:
Atrial fibrillationDiabetic ketoacidosisNational In patient SampleOutcome

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