2275-P: Diabetes as a Disease-Specific Modifier of Inpatient Outcomes across High-Acuity Medical Admissions: An Analysis of the 2016–2023 NIS

Introduction and Objective: Diabetes mellitus (DM) is common among hospitalized adults and is a risk factor for numerous medical conditions. Here we explore if patients with DM have additional inpatient mortality risk across different diseases, and if this varies in the teaching hospital setting. Methods: The National Inpatient Sample was used to perform a serial cross-sectional analysis of 54,944,092 adult patients admitted to urban hospitals between 2016-2023, stratified by teaching hospital status. Four cohorts of patients with DM were identified by reason for admission using ICD-10-CM codes: CHF, COPD, acute myocardial infarction (AMI), and stroke. Survey-weighted logistic and linear regression models were used to analyze the impact of DM and teaching hospital status on our primary outcomes of mortality and length of stay (LOS). CHF mortality models were adjusted for APR-DRG severity. Results: Patients with DM had higher mortality in AMI (OR 1.10, 95% CI 1.06-1.16), but lower mortality in COPD (OR 0.75, 95% CI 0.67-0.84) and stroke (OR 0.76, 95% CI 0.72-0.79). Teaching hospitals had higher mortality in COPD (OR 1.09, 95% CI 1.02-1.16), AMI (OR 1.15, 95% CI 1.11-1.19), and stroke (OR 1.54, 95% CI 1.48-1.60). Severity adjusted CHF mortality was unaffected by DM or teaching hospital status. Patients with DM had longer LOS across cohorts: +0.23 days in COPD (95% CI 0.19-0.27), +0.86 days in AMI (95% CI 0.81-0.90), and +0.37 days in stroke (95% CI 0.31-0.44). Teaching hospitals had longer LOS across cohorts (COPD +0.18 days; AMI +0.75 days; stroke +1.54 days), and DM status altered this (COPD +0.05 days; AMI +0.25 days; stroke -0.20 days). Conclusion: Despite increasing mortality risk in AMI, DM unusually decreases risk in COPD and stroke, a finding that requires more research to explain. Teaching hospitals had higher mortality and LOS across cohorts. Developing disease-specific strategies could mitigate DM-related risk during hospitalization. Disclosure J. Everett: None. P. Chaganlal: None. D.T. Jones: None. P. Shah: None.