Abstract Rationale Social deprivation is associated with a longer length of hospital stay (LOS) in children with diabetic ketoacidosis (DKA). However, there is limited data in adults. DKA has a significant social burden, and targeting modifiable factors may help reduce LOS and patient outcomes. In this study, the hypothesis was that patients admitted for DKA from socially deprived areas have a longer LOS in the ICU. Methods This study was a single-center retrospective observational cohort study that included DKA patients admitted to the ICU at the University Hospital at Downstate between June 2019 and May 2024. Individual Social Deprivation Index (SDI) scores from 0 to 100 were assigned to the patients from the Robert Graham Center publicly available dataset based on their zip code. Higher scores indicated more social deprivation. Different demographic, clinical, and observational data points were extracted from the charts. A Poisson regression model was used to assess the association between SDI and the ICU LOS, adjusted for variables such as gender, age, race, number of comorbidities, and body mass index (BMI). Results The final sample included 45 patients. The Poisson regression demonstrated that SDI was negatively associated with the length of ICU stay (IRR = 0.94, 95% CI: 0.93-0.94, p 0.001), indicating that the patients from areas with higher deprivation had shorter ICU stays (Figure 1). Conversely, the number of comorbidities, as expected, was associated with increased ICU stay (IRR = 1.24, 95% CI: 1.14-1.34, p 0.001), with each additional comorbidity increasing the ICU days by 24%. Additionally, the patients with Class II obesity (BMI ≥ 40) also had a longer ICU LOS compared to those with normal/overweight BMI (IRR = 1.59, 95% CI: 1.13-2.21, p = 0.007). White race was associated with a reduced ICU stay relative to Black/African American patients (IRR = 0.59, 95% CI: 0.39-0.88, p = 0.011). Gender and age were not found to be significantly associated with LOS. The regression model demonstrated a good fit (Residual deviance = 203.78, df = 37, p 0.001). Conclusion This study uniquely used the Social Deprivation Index (SDI) as a measure of social deprivation. It showed that a higher SDI was associated with a shorter ICU length of stay. Heterogeneity within the same zip code areas could explain this association, and further studies are needed to explore it. This abstract is funded by: none
Kalra et al. (Fri,) studied this question.