SAT-287 Impact of Hospital Teaching Status on Outcomes in Myxedema Coma: An Analysis of the National Inpatient Sample

Abstract Disclosure: S. Prasad: None. G. Das: None. M. Souleymane: None. S. Balasubramanian: None. S. Ball: None. M. Singh: None. D. Thor: None. S. Patel: None. A. Jala: None. R. Patel: None. R. Viswanathan: None. M. Lee: None. Y. Wang: None. Background: Myxedema coma is a rare but life-threatening endocrine emergency requiring prompt recognition and management. While timely intervention is critical, the influence of hospital setting—teaching hospitals (TH) vs. non-teaching hospitals (NTH)—on patient outcomes remains unclear. THs often provide specialized expertise and critical care resources but may be associated with higher healthcare costs and procedural interventions. This study evaluates differences in outcomes, resource utilization, and demographics between TH and NTH admissions for myxedema coma. Methods: Using the National Inpatient Sample (NIS) from 2015-2022, adult patients (>18 years) with a primary diagnosis of myxedema coma were identified and stratified by admission to TH vs. NTH. The primary outcome was in-hospital mortality. Secondary outcomes included length of stay (LOS), total hospitalization costs, complications, and interhospital transfers. Multivariate logistic regression and Fisher’s exact test were used for statistical analysis. Results: Among 7,555 patients, 72.6% were admitted to THs and 27.4% to NTHs (p<0.005). TH patients were more likely to have a higher Charlson comorbidity index (2.7 vs. 2.3, p<0.005). Mortality was similar between TH and NTH admissions. However, TH patients had higher odds of requiring intubation, vasopressors, and developing acute kidney injury. NTH patients had 2.6 times higher odds of interhospital transfer. TH admissions were associated with increased costs ($106,316 vs. $82,133, p<0.005) and longer LOS (10.3 vs. 8.52 days, p=0.002). Over the 8-year period, no significant shift occurred in the distribution of TH vs. NTH hospitalizations for myxedema coma. Conclusion: Despite similar mortality rates between TH and NTH admissions, significant differences in clinical management, resource utilization, and interhospital transfer rates suggest that disparities in care delivery may exist. The higher rates of intubation, vasopressor use, and acute kidney injury in THs may reflect differences in disease severity at presentation, more aggressive management strategies, or variations in institutional protocols. Conversely, the increased likelihood of interhospital transfer from NTHs may indicate potential limitations in access to critical care resources. These findings highlight the complexity of managing myxedema coma and underscore the need for further research to determine whether these variations in care translate into meaningful differences in long-term outcomes, quality of care, and cost-effectiveness. Presentation: Saturday, July 12, 2025