2259-P: Seasonal Variation among Hospitalized Adults with Hyperglycemic Crises in the United States

Introduction and Objective: Hyperglycemic crises, including diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS), remain important causes of diabetes-related morbidity and mortality. National data describing seasonal variation in incidence and outcomes are limited. We examined seasonal patterns and predictors of in-hospital outcomes among U.S. adults hospitalized with hyperglycemic crises. Methods: We conducted a retrospective analysis of adult (≥18 years) hospitalizations for DKA and HHS using the 2022 Nationwide Readmissions Database. Admissions were identified using ICD-10-CM codes and categorized by season. Survey-weighted multivariable regression models adjusted for demographics, payer status, comorbidities, hospital characteristics, disease severity, and acute infectious precipitants were used to evaluate in-hospital mortality, cardiac arrest, length of stay (LOS), mechanical ventilation (MV), and total hospital charges. Results: An estimated 237,904 hospitalizations for hyperglycemic crises occurred in 2022. Admissions peaked in winter (26.5%) and were lowest in summer (24.5%), with bimodal monthly peaks in December (9.42%) and January (9.41%). Overall in-hospital mortality was low (0.73%) but highest in winter (0.97%) compared with summer (0.61%). After adjustment, winter admissions were associated with higher odds of in-hospital mortality (adjusted odds ratio aOR 1.46 p0.001) and cardiac arrest (aOR 1.36, p=0.015). Sepsis was the strongest predictor of mortality (aOR 10.54, p0.001). No significant seasonal differences were observed in MV, LOS, or total hospital charges. Conclusion: Hospitalizations for hyperglycemic crises show significant seasonal variation, with higher mortality observed during winter admissions. While the mechanisms underlying this association remain uncertain, these findings suggest that seasonal factors may influence outcomes and warrant further investigation to inform risk stratification and preventive strategies. Disclosure T. Anagreh: None. L. Sorour: None. B. Varghese: None.