Type 2 diabetes increases the risk of hospital admission for heart failure and reduces the risk of in hospital mortality in Spain (2001-2015).
Adult
Age Distribution
Aged
Aged, 80 and over
Databases, Factual
Diabetes Mellitus, Type 2
/ complications
Female
Heart Failure
/ mortality
Hospital Mortality
/ trends
Hospitalization
/ trends
Humans
Incidence
Linear Models
Logistic Models
Male
Middle Aged
Multivariate Analysis
Retrospective Studies
Risk Factors
Sex Distribution
Spain
/ epidemiology
Heart failure
Hospitalization
In-hospital mortality
Incidence
Length of stay
Type 2 diabetes mellitus
Journal
European journal of internal medicine
ISSN: 1879-0828
Titre abrégé: Eur J Intern Med
Pays: Netherlands
ID NLM: 9003220
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
06
06
2018
revised:
24
07
2018
accepted:
15
08
2018
pubmed:
26
8
2018
medline:
22
5
2019
entrez:
26
8
2018
Statut:
ppublish
Résumé
To compare trends in incidence, clinical characteristics and outcomes of heart failure (HF) hospitalizations among patients with or without type 2 diabetes (T2DM) in Spain (2001-2015). We used national hospital discharge data to select hospital admissions for HF as primary diagnosis. Incidence, comorbidities, diagnostic and therapeutic procedures, and in hospital mortality (IHM) were analyzed. We identified a total of 1,501,811 admissions for HF (36.87% with T2DM). Incidences were higher among those with T2DM than those without diabetes. The adjusted incidence of HF among T2DM patients was 4.93 higher than for non-diabetic subjects (IRR 4.93;95%CI 4.91-4.95). Jointpoint analysis showed that sex-age-adjusted admissions in T2DM patients with HF increased by 7.12% per year from 2001 to 2007 and stabilized afterwards. For non-diabetic patients a constant increase overtime of around 1% was found. Patients with T2DM were significantly younger than patients without diabetes (77.22 vs. 79.36 years) and had more coexisting medical conditions according to the Charlson Comorbidity Index (mean CCI 1.99 ± 0.88 vs. 1.90 ± 0.86). For the total time period, crude IHM was lower for T2DM patients than for non-diabetic people (8.35% vs, 10.57%; p < 0.05) and the association remained significant after multivariable adjustment ((OR, 0.84; 95%CI 0.83-0.86).). Female sex, older age and multiple comorbidities were significant risk factors for IHM. T2DM increases the risk of admission for HF by five-fold. Our study demonstrates an increase in hospitalization for HF in diabetic patients from 2001 to 2007 and stabilization afterwards. T2DM was associated with a lower IHM after hospitalization for HF.
Sections du résumé
BACKGROUND
To compare trends in incidence, clinical characteristics and outcomes of heart failure (HF) hospitalizations among patients with or without type 2 diabetes (T2DM) in Spain (2001-2015).
METHODS
We used national hospital discharge data to select hospital admissions for HF as primary diagnosis. Incidence, comorbidities, diagnostic and therapeutic procedures, and in hospital mortality (IHM) were analyzed.
RESULTS
We identified a total of 1,501,811 admissions for HF (36.87% with T2DM). Incidences were higher among those with T2DM than those without diabetes. The adjusted incidence of HF among T2DM patients was 4.93 higher than for non-diabetic subjects (IRR 4.93;95%CI 4.91-4.95). Jointpoint analysis showed that sex-age-adjusted admissions in T2DM patients with HF increased by 7.12% per year from 2001 to 2007 and stabilized afterwards. For non-diabetic patients a constant increase overtime of around 1% was found. Patients with T2DM were significantly younger than patients without diabetes (77.22 vs. 79.36 years) and had more coexisting medical conditions according to the Charlson Comorbidity Index (mean CCI 1.99 ± 0.88 vs. 1.90 ± 0.86). For the total time period, crude IHM was lower for T2DM patients than for non-diabetic people (8.35% vs, 10.57%; p < 0.05) and the association remained significant after multivariable adjustment ((OR, 0.84; 95%CI 0.83-0.86).). Female sex, older age and multiple comorbidities were significant risk factors for IHM.
CONCLUSIONS
T2DM increases the risk of admission for HF by five-fold. Our study demonstrates an increase in hospitalization for HF in diabetic patients from 2001 to 2007 and stabilization afterwards. T2DM was associated with a lower IHM after hospitalization for HF.
Identifiants
pubmed: 30143395
pii: S0953-6205(18)30336-4
doi: 10.1016/j.ejim.2018.08.011
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
53-59Informations de copyright
Copyright © 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.