Conference Coverage

Men Face Higher Mortality and Arrhythmia Risk, Women More Prone to Heart Failure in DKA Hospitalizations

Kate Young

Key Highlights

  • Men hospitalized for diabetic ketoacidosis (DKA) had significantly higher odds of all-cause mortality and arrhythmic events than women.
  • Women were more likely to experience acute heart failure and pericardial effusion during DKA hospitalization than men.
  • No gender differences were observed in cardiogenic shock rates.

A nationwide retrospective cohort study analyzed over 1.4 million hospitalizations for diabetic ketoacidosis (DKA) from 2015 to 2022, revealing notable gender-based disparities in cardiovascular outcomes. Men faced significantly higher odds of all-cause mortality and arrhythmic complications, while women had elevated risks of acute heart failure and pericardial effusion.

Given the severe nature of DKA and its frequent need for intensive care, the study aimed to clarify whether gender differences influence cardiovascular complications and resource utilization during hospitalization. Prior studies have explored sex-related variability in diabetes complications, but cardiovascular risks associated specifically with DKA by gender remained insufficiently characterized.

Using the National Inpatient Sample (NIS) database and ICD-10 diagnostic codes, researchers examined adult patients admitted primarily for DKA between 2015 and 2022. Patients were stratified by gender, and multivariate logistic regression was applied to account for demographics and clinical comorbidities. Key outcomes included mortality, arrhythmias, acute coronary syndrome, acute heart failure, pericardial effusion, total hospitalization cost, and length of stay.

Among the 1,461,434 DKA hospitalizations, 51.6% were men and 48.4% women, with comparable demographic distributions. Women had a marginally higher comorbidity index and longer hospital stays. However, men demonstrated significantly increased risks of all-cause mortality (aOR 1.25), cardiac arrest (aOR 1.27), atrial arrhythmia (aOR 1.37), and ventricular arrhythmia (aOR 1.31). In contrast, women were more likely to develop acute heart failure (aOR 1.30) and pericardial effusion (aOR 1.34). Cardiogenic shock rates did not differ significantly between genders.

“These findings highlight the need for gender-specific risk assessment and management strategies in patients with DKA to improve clinical outcomes,” the study authors concluded. “Further research is warranted to explore underlying physiological and clinical factors contributing to these differences.”

Reference:
Prasad S, Ball S, Jala A, et al. Gender-based differences in cardiovascular outcomes among patients hospitalized for diabetic ketoacidosis: a nationwide analysis. Poster presented at: ENDO 2025; July 12-15, 2025; San Francisco, CA. https://www.endocrine.org/meetings-and-events/endo-2025