Dimpi Desai|Dhruv Mehta|Priyanka Mathias|Gopal Menon|Ulrich K. Schubart
Health Care Utilization and Burden of Diabetic Ketoacidosis in the U.S. Over the Past Decade: A Nationwide Analysis
Jacobi Medical Center|Westchester Medical Center|New York Medical College|Jacobi Medical Center|Harvard Global Health Institute|Jacobi Medical Center
objective diabetes one common chronic diseases leading cause morbidity mortality us although ability treat diabetes associated complications significantly improved presentation uncontrolled diabetes leading ketoacidosis remains significant problem research design methods aimed determine incidence costs hospital admissions associated diabetic ketoacidosis dka reviewed national inpatient sample database hospitalizations dka icd9 codes 25010 25011 25012 25013 principal discharge diagnosis 20032014 calculated population incidence using us census data patients icd9 codes diabetic coma excluded codes distinguish hypoglycemic dkarelated coma analyzed changes temporal trends incidence length stay costs inhospital mortality using cochranearmitage test results 1760101 primary admissions dka study period inhospital mortality cohort 04 n 7031 total number hospital discharges principal diagnosis dka increased 118808 2003 188965 2014 p amplt 00001 length stay significantly decreased average 364 days 2003 324 days 2014 p amplt 001 period mean hospital charges increased significantly 18987 adjusting inflation per admission 2003 26566 per admission 2014 resulting aggregate charges ie national bill diabetes ketoacidosis increased dramatically 22 billion adjusting inflation 2003 51 billion 2014 p amplt 0001 however significant reduction mortality 611 051 2003 620 03 2014 p amplt 001 conclusions analysis shows population incidence dka hospitalizations us continues increase mortality condition significantly decreased indicating advances early diagnosis better inpatient care despite decreases length stay costs hospitalizations increased significantly indicating opportunities valuebased care intervention vulnerable population