0042Diabetes and Cardiorenal Risk as Predictors of 30-Day Outcomes After Heart Failure Hospitalization

Background Diabetes is a key cardiometabolic driver of heart failure morbidity and commonly coexists with renal dysfunction. Identifying diabetes-related cardiorenal risk before discharge may improve post-hospital risk stratification. Objective To evaluate associations of diabetes and severe renal dysfunction with 30-day death or heart failure readmission after heart failure hospitalization. Methods We performed a retrospective cohort study using MIMIC-IV v3.1. Adults with a first qualifying heart failure hospitalization were included. Diabetes was identified using diagnosis codes. Severe renal dysfunction was defined as creatinine ≥2.0 mg/dL within 24 hours of admission. The primary outcome was all-cause death or heart failure readmission within 30 days. Logistic regression adjusted for age, sex, diabetes, and severe renal dysfunction. Results Among 31,369 first heart failure hospitalizations, 13,920 patients (44.4%) had diabetes. Creatinine was available in 28,637 patients (91.3%), and 5,499 (17.5%) had severe renal dysfunction. The overall 30-day event rate was 19.6%. Events were more common in patients with diabetes than without diabetes (20.5% vs 18.8%), driven by higher heart failure readmission (14.8% vs 11.7%). Diabetes remained independently associated with 30-day events after adjustment for severe renal dysfunction (adjusted odds ratio [OR] 1.09, 95% confidence interval [CI] 1.03-1.16). Severe renal dysfunction was a stronger independent predictor (adjusted OR 1.55, 95% CI 1.44-1.66). Conclusions Diabetes was common and independently associated with early adverse outcomes after heart failure hospitalization. Severe renal dysfunction amplified risk, supporting diabetes-focused cardiorenal risk assessment before discharge. Is this an encore abstract? No