SAT-645 Gender-Based Differences in Cardiovascular Outcomes Among Patients Hospitalized for Diabetic Ketoacidosis: A Nationwide Analysis

Abstract Disclosure: S. Prasad: None. S. Ball: None. A. Jala: None. S. Gupta: None. M. Singh: None. R. Patel: None. M. Souleymane: None. S. Balasubramanian: None. M. Lee: None. D. Thor: None. Y. Wang: None. Introduction: Diabetic ketoacidosis (DKA) is a serious and potentially fatal complication of diabetes mellitus, often requiring intensive medical intervention. While gender-based differences in diabetes-related complications have been studied, the impact of gender on cardiovascular outcomes in DKA hospitalizations remains unclear. Understanding these disparities is crucial for optimizing risk stratification and management strategies in this population. Objective: To evaluate gender-based differences in cardiovascular complications, mortality, and healthcare resource utilization among patients hospitalized for DKA. Methods: This retrospective cohort study utilized the National Inpatient Sample (NIS) database from 2015 to 2022. Adults (≥18 years) with a primary diagnosis of DKA were identified using ICD-10 codes and stratified by gender. Primary outcomes included all-cause mortality, arrhythmias, acute coronary syndrome (ACS), acute heart failure (AHF), pericardial effusion, total hospitalization cost, and length of stay (LOS). Multivariate logistic regression models were used to adjust for demographic factors and clinical comorbidities. Results: A total of 1,461,434 DKA hospitalizations were analyzed, with 51.6% occurring in males and 48.4% in females. Mean age, socioeconomic status, and racial distribution were comparable between groups. Females had a slightly higher Charlson Comorbidity Index (2.0 vs. 1.9, p<0.05) and longer LOS (3.4 vs. 3.1 days, p<0.005).Males exhibited significantly higher all-cause mortality (aOR 1.25, p=0.021) and were more likely to experience cardiac arrest (aOR 1.27, p<0.005), atrial arrhythmia (aOR 1.37, p<0.005), and ventricular arrhythmia (aOR 1.31, p<0.005). Conversely, females had greater odds of developing AHF (aOR 1.30, p<0.005) and pericardial effusion (aOR 1.34, p=0.018). No significant differences were observed in rates of cardiogenic shock. Conclusion: Significant gender-based disparities exist in cardiovascular outcomes among patients hospitalized for DKA. Males demonstrated higher mortality and arrhythmic complications, whereas females were more likely to develop heart failure and pericardial effusion. These findings highlight the need for gender-specific risk assessment and management strategies in patients with DKA to improve clinical outcomes. Further research is warranted to explore underlying physiological and clinical factors contributing to these differences. Presentation: Saturday, July 12, 2025