Nuria Muñoz-Rivas1, Rodrigo Jiménez-García2, Manuel Méndez-Bailón3, Valentín Hernández-Barrera4, Javier de Miguel-Díez5, Noel Lorenzo-Villalba6, José M de Miguel-Yanes7, Ana López-de-Andrés4. 1. Medicine Department, Hospital Universitario Infanta Leonor, Madrid, Spain. 2. Preventive Medicine and Public Health Teaching and Research Unit, Rey Juan Carlos University, Alcorcón, Madrid, Spain. Electronic address: rodrigo.jimenez@urjc.es. 3. Internal Medicine Department, Clínico San Carlos University Hospital, Medicine Department, Complutense University of Madrid (UCM), Clínico San Carlos Hospital Biomedical Research Institute (IdISSC), Madrid, Spain. 4. Preventive Medicine and Public Health Teaching and Research Unit, Rey Juan Carlos University, Alcorcón, Madrid, Spain. 5. Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain. 6. Service de Medicine Interne, Centre Hospitalier Chretien, Liege, Belgium. 7. Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain.
Abstract
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.
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-diabeticpatients 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 diabeticpatients from 2001 to 2007 and stabilization afterwards. T2DM was associated with a lower IHM after hospitalization for HF.
Authors: Esteban Jodar; Sara Artola; Xavier Garcia-Moll; Estefany Uría; Noemí López-Martínez; Rosa Palomino; Virginia Martín Journal: BMJ Open Diabetes Res Care Date: 2020-07