(5.08) Comparative Analysis of In-Hospital Mortality and Healthcare Burden in Central versus Nephrogenic Diabetes Insipidus: A Glimpse of the National Inpatient Sample
Endocrinology Fellow St. Louis University Hospital SAINT LOUIS, Missouri, United States
Objective : Diabetes Insipidus (DI) primarily manifests as Central Diabetes Insipidus (CDI) and Nephrogenic Diabetes Insipidus (NDI). CDI caused by inadequate arginine vasopressin (AVP) secretion contrasts with NDI, which is renal insensitive to AVP. Our study explored the disparities in in-hospital mortality and healthcare burden between patients with CDI and NDI, underscoring demographic, clinical, and economic aspects.
Methods: Using the National Inpatient Sample (2016-2020), this retrospective cohort study analyzed 5,460 patients with DI and categorized them into 4,375 CDI and 1,085 NDI cases. Key outcomes included in-hospital mortality, length of hospital stay (LOS), and total hospital charge. We employed multiple imputations for missing data and conducted multivariate logistic and linear regressions for the outcome analyses. Statistical significance was set at P < 0.05.
Results: The study revealed significant age differences between the groups, with NDI patients being older (mean age 60.67 years) than CDI patients (mean age 48.36 years, P< 0.001). Both groups had a balanced sex distribution. CDI showed a higher prevalence among black individuals than NDI (26.85% vs. 12.09%, P< 0.001). Mortality rates did not differ significantly between the CDI and NDI groups (1.03% vs. 1.84%, P=0.323). NDI patients experienced more extended hospital stays and higher charges (mean LOS of 10.36 days, mean charge of $68,829.39) compared to CDI patients (mean LOS of 7.56 days, mean charge of $53,720.7, P=0.003, and P=0.014, respectively). In addition, a higher comorbidity index was observed in patients with NDI.
Discussion/Conclusion: Our study indicated no significant difference in mortality between CDI and NDI inpatients. However, patients with NDI face more significant healthcare challenges, including older age, increased comorbidities, more extended hospital stays, and higher costs. These findings highlight the necessity for differentiated healthcare approaches for managing DI, considering the distinct demographic and clinical profiles of patients with CDI and NDI.
