SUN-597 Impact of Malnutrition among Hospitalized Patients with Diabetic Ketoacidosis : A United States Population-Based Cohort Study

Abstract Disclosure: C. Casipit: None. M. Barnett: None. J. Lam: None. A. Rivadeneira Rodriguez: None. B. Casipit: None. Background: Malnutrition is prevalent among patients with diabetes and is a risk factor for increased morbidity and mortality among hospitalized patients. However, there is a paucity of data regarding the impact of malnutrition among hospitalized patients with Diabetic Ketoacidosis (DKA) using a national database. Methods: We utilized the 2018-2020 United States National Inpatient Sample (NIS) Database in conducting this population-based retrospective cohort study. We identified patients hospitalized for DKA with concomitant malnutrition during the index hospitalization using appropriate ICD-10 CM and PR codes. We aim to investigate the impact of malnutrition among patients with DKA based on in-hospital mortality, the risk for acute respiratory failure, and the utilization of mechanical ventilation. A survey multivariable logistic and linear regression analysis was used to calculate the adjusted odds ratios (ORs) for the outcomes of interest. A p-value of <0.05 was considered statistically significant. Results: A total of 98,372 hospitalized patients with DKA were identified in the years 2018-2020, of which 11.06% (10,880/98,373) had concomitant malnutrition. The overall in-hospital mortality rate among DKA patients was 3.1% (3,050/98,372). Among those with concomitant malnutrition, the overall in-hospital mortality rate was significantly higher at 5.65% (614/10,880, p=<0.001). Using a stepwise survey multivariable logistic regression model that adjusted for patient and hospital level confounders, concomitant malnutrition among hospitalized patients with DKA was independently associated with increased risk for in-hospital mortality (adjusted OR [aOR] 1.44; 95% confidence interval [CI], 1.16-1.80; p=<0.001), acute respiratory failure (aOR 1.84; 95% CI, 1.63-2.07; p=<0.001) and utilization of mechanical ventilation (aOR 2.00; 95% CI, 1.76-2.27; p=<0.001). Conclusion: Our study showed that concomitant malnutrition among hospitalized patients with DKA was independently associated with increased risk for in-hospital mortality, acute respiratory failure, and utilization of mechanical ventilation. Our study highlights the need for physicians to give individualized patient education regarding proper nutrition, make a routine nutritional assessment, and provide prompt treatment of nutritional needs while coordinating a multidisciplinary approach to optimize nutrition in all patients, particularly diabetic patients who are already in a state of nutritional imbalance and at risk for life-threatening complications. Presentation: Sunday, July 13, 2025