SAT-649 Evaluating Inpatient vs. Outpatient Disparities in DKA Mortality in the United States (1999-2022): Insights from the CDC WONDER Database

Abstract Disclosure: S. Soni: None. S. Govekar: None. V. Gill: None. A. Grover: None. M.M. Vasudevan: None. Background: Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes, primarily affecting individuals with type 1 diabetes under severe stress. Hospital-based mortality is a key indicator of healthcare outcomes, with previous studies suggesting potential disparities by age and gender. This study investigates the distribution of inpatient and outpatient deaths across age groups and genders, focusing on hospital-based mortality. Understanding these trends is critical to developing interventions that reduce mortality and address healthcare inequities. Methods: We used the CDC WONDER (Wide-ranging Online Data for Epidemiologic Research) database, which is a publicly accessible online platform designed to facilitate epidemiologic research and public health surveillance. We investigated the underlying cause of death and analyzed DKA-related mortality in the U.S. from 1999 to 2022. We extracted the mortality of ICD-10 codes E10.0, 10.1,1 1.0, 11.1, 13.0, 13.1, 14.0 and 14.1. Mortality data was stratified according to gender, race, 10-year age group (up to 85+ years), and place of death (Inpatient/Outpatient/Nursing Home/Hospice/Home). Odds ratios and p-values were calculated to assess age-based, sex-based, and race-based associations with the place of death. Statistical analysis was done using R-software, and a p-value < 0.05 was considered statistically significant. Results: The data analysis revealed significant findings regarding the distribution of inpatient and outpatient cases across age groups and genders. The highest number of inpatient deaths occurred in the 45-54 age group, while the 85+ age group had the lowest inpatient deaths. Outpatient deaths were most frequent in the 25-34 age group (28.93%), with a steady decrease as age increased. Females received a larger proportion of hospital-based care, with 51.07% of hospital deaths attributed to women, compared to 48.93% for men. Furthermore, the odds ratio for hospital-based deaths among females was 1.96 (95% CI: 1.89-2.02), indicating that females were almost twice as likely to die in a hospital setting compared to males, with a (p-value<0.05).Conclusion: The results reveal significant gender disparities in hospital-based mortality, with females being nearly twice as likely to die in a hospital setting compared to males. Age-related trends show the highest number of inpatient deaths in the 45-54 age group and the highest outpatient death percentage in the 25-34 age group. These findings highlight the need for further research to address gender and age-related disparities in hospital mortality and to develop targeted healthcare interventions. To our knowledge, this is the first study to comprehensively analyze hospital-based DKA mortality with a focus on gender disparities using the CDC WONDER database. Presentation: Saturday, July 12, 2025