0044Hypoglycemia and Renal Dysfunction Identify High-Risk Patients With Diabetes After Heart Failure Hospitalization

Background Hypoglycemia and renal dysfunction are common in diabetes and may reflect high-risk cardiometabolic vulnerability during heart failure hospitalization. Objective To evaluate whether early hypoglycemia and severe renal dysfunction jointly predict 30-day death or heart failure readmission among patients with diabetes hospitalized for heart failure. Methods We performed a retrospective cohort study using MIMIC-IV v3.1. Adults with diabetes and a first qualifying heart failure hospitalization were included if glucose and creatinine data were available within 24 hours of admission. Hypoglycemia was defined as any glucose <70 mg/dL, and severe renal dysfunction as creatinine ≥2.0 mg/dL. Patients were categorized as having neither marker, hypoglycemia alone, severe renal dysfunction alone, or both. The primary outcome was all-cause death or heart failure readmission within 30 days. Logistic regression adjusted for age and sex. Results Among 12,515 patients, 542 (4.3%) had hypoglycemia, 2,993 (23.9%) had severe renal dysfunction, and 216 (1.7%) had both. The overall 30-day event rate was 24.4%. Event rates were 22.4% with neither marker, 27.3% with hypoglycemia alone, 29.6% with severe renal dysfunction alone, and 38.4% with both. Compared with neither marker, severe renal dysfunction alone (odds ratio [OR] 1.50, 95% confidence interval [CI] 1.36-1.65) and concurrent hypoglycemia plus severe renal dysfunction (OR 2.25, 95% CI 1.70-2.98) were associated with higher early risk. Conclusions In patients with diabetes hospitalized for heart failure, early hypoglycemia combined with severe renal dysfunction identified a high-risk cardiorenal-metabolic phenotype. Integrating glucose and renal markers may improve discharge risk stratification. Is this an encore abstract? No