B-97 | Impact of Intravenous Fluid Shortage After Hurricane Helene on Cardiac Catheterization Outcomes

Diabetic Ketoacidosis (DKA) patients.This study explored the association between AF and DKA in Texas.Methods: We used a statewide dataset to identify hospitalizations aged 18 years with DKA in Texas during 2022.DKA was defined by ICD-10 codes E08-E13, and AF by code I48.Hierarchical, mixed effects logistic regression models, which included the Elixhauser comorbidity index, were used to estimate the association of AF with in-hospital mortality among DKA hospitalizations.We compared hospitalizations based on AF onset, defined by the presence of the present-on-admission indicator.Results: There were 56,990 DKA hospitalizations in the study period, of which 1,385 (2.4%) had concurrent AF.DKA hospitalizations with AF were older (65 years: 47.7% vs 8.9%), more commonly male (54.2% vs 48.5%), and of White race (59.2% vs 43.3%) compared to those without AF.Patients with DKA and AF were more likely to be admitted to the ICU (87.4% vs 81.7%) and had a higher in-hospital mortality rate (2.2% vs 0.4%) compared to those without AF.Additionally, only 56.9% of patients with AF had a routine home discharge compared to 84.7% without AF.Hospitalizations with AF onset during current admission had even higher ICU utilization (96.3% vs 86.8%), liver disease (13.6% vs 7.2%), lower comorbid heart failure (21% vs 26.8%), and higher mortality rate (8.6% vs 1.8%).On adjusted analysis, the in-hospital mortality was significantly higher in patients with DKA and hospital-onset AF, with an adjusted odds ratio of 5.74 (95% CI 1.89-13.43).Patients with atrial fibrillation were less likely to have private insurance (38.0% vs. 40.0%)but more likely to have Medicare coverage (38.0% vs. 12.2%).Uninsured rates were also lower in this group (15.0% vs. 33.6%).Conclusions: AF and DKA are associated with significantly worse outcomes, including higher in-hospital mortality and ICU admissions, as well as a lower likelihood of routine home discharge.The presence of AF increases the risk of in-hospital mortality by over fivefold, underscoring the need for targeted management of this high-risk group.