Impact Of Diabetes Mellitus On Copd Hospitalizations: Data From The National Inpatient Sample

SESSION TITLE: Obstructive Lung Disease Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Chronic obstructive pulmonary disease (COPD) is the leading cause of morbidity and mortality worldwide. Diabetes has been shown to have adverse inflammatory effects on lung anatomy and physiology. In this study, we investigated the impact of DM on COPD patient outcomes during inpatient hospitalization. METHODS: We conducted a retrospective analysis of COPD-associated hospitalizations Nationwide Inpatient Sample (NIS) over the years 2002-2014. Three groups COPD without diabetes, COPD with diabetes but no complication and COPD with DM and complications were analyzed as a secondary diagnosis. Length of stay, in-hospital mortality, and incidence of pneumonia, was assessed. Study analysis was done using IBM SPSS software for complex sample analysis with stratification variable, cluster variable and weight variable accounting for sampling method of NIS to estimate national estimates. RESULTS: Evaluation of 7,498,577 patients(age>18) hospitalized with primary diagnosis of COPD of those 1,799,637 had DM without complications and 483,467 had DM with complications. Most admissions were made up of Caucasian and AA race (66.8% and 8.1%). The mean age at admission was 68.92 years (interquartile range [IQR]), 68.86-68.98 years) and 4192974 (55%) were females. As expected, hypertension (72.6% vs 53.6%) and heart failure (40% vs 21.3%) was found more in the DM with complications group than without DM group. Obesity was found more in the COPD with DM with complications than with COPD alone (28.2% vs 6.6%). Mean length of stay (LOS) (>4 days) was longest for COPD and DM with complication and shortest for COPD without Diabetes (60.8% vs 51%; p =0.0001). After adjusting for clinical, demographic, and comorbidities, the odds of increased LOS in the COPD/DM with complication was 1.37 (CI: 1.326 -1.368) and DM without complication was 1.061(1.052-1.070) when compared with COPD with no DM. The odds of pneumonia and respiratory failure were not significant across the group. Surprisingly both DM with complication [OR:0.751 (CI 0.727-0.777)] and DM without complication [OR:0.635(CI: 0.596-0.675)] has lesser odds of mortality during the hospitalization than with COPD alone. Hospital charges were highest for DM with complication than with COPD alone ($21321 vs $27328, p=<0.0001.) CONCLUSIONS: There are a considerable inpatient burden in terms of LOS and hospital charges among COPD patients with DM in the United States. Mortality seems to better in the COPD group with DM with/without complications. CLINICAL IMPLICATIONS: Identifying causes of mortality among COPD patients without DM will enable targeted interventions for these individuals. Further studies should evaluate the impact of DM on outcomes. DISCLOSURES: No relevant relationships by Kalaimani Elango, source=Web Response no disclosure submitted for Adiba Geeti; No relevant relationships by Kulothungan Gunasekaran, source=Web Response No relevant relationships by Jeff Kwon, source=Web Response No relevant relationships by Dinesh Voruganti, source=Web Response