Highlights
- •Patients with diabetes mellitus are admitted to hospital more often.
- •Hospitalizations of patients with diabetes have gradually increased over time.
- •Heart failure and neoplasms are the main causes of hospitalizations for diabetics.
- •Hospitalized diabetic patients are progressively older and have more comorbidities.
- •Hospitalization trends for coronary and cerebrovascular disease are less pronounced.
Abstract
Aims
To analyze national trends in the rates of hospitalizations (all-cause and by principal
discharge diagnosis) in total diabetic population of Spain.
Methods
We carried out a nation-wide population-based study of all diabetic patients hospitalized
between 1997 and 2010. All-cause hospitalizations, hospitalizations by principal discharge
diagnosis, mean age, Charlson Comorbidity Index, readmission rates and length of hospital
stay were examined. Annual rates adjusted for age and sex were analyzed and trends
were calculated.
Results
Over 14-years-period, all-cause hospitalizations of diabetic patients increased significantly,
with an average annual percentage change of 2.5 (95%CI: 1.5–3.5; Ptrend < 0.01). The greatest increase was observed in heart failure (5.4; 95%CI: 4.8–6.0;
Ptrend < 0.001), followed by neoplasms (4.9; 95%CI: 3.6–5.8; Ptrend < 0.001), pneumonia (2.7; 95%CI: 2.0–4.0; Ptrend < 0.001), stroke (2.4; 95%CI: 1.6–3.4; Ptrend < 0.001), chronic obstructive pulmonary disease (2.0; 95%CI: 1.4–3.4; Ptrend < 0.001) and coronary artery disease (1.6; 95%CI: 1.1–2.3; Ptrend < 0.01). The adjusted number of all-cause hospitalizations of patients with diabetes
per 100,000 inhabitants increased 2.6-fold. The increase in hospitalizations was significantly
higher among patients ≥75 years old. Males experienced a greater increase in all-cause,
neoplasm, heart failure, chronic obstructive pulmonary disease, and pneumonia hospitalizations
(p < 0.01 for all). Hospitalized diabetic patients were progressively older and had
more comorbidities, higher readmission rates and shorter hospital stays (p < 0.05
for all).
Conclusions
Hospitalizations of diabetic patients more than doubled in Spain during the study
period. Heart failure and neoplasms experienced the greatest annual increases and
remained the principal causes of hospitalization, probably associated with advanced
age and comorbidities of hospitalized diabetics. Coronary and cerebrovascular diseases
experienced a lower annual increase, suggesting an improvement in cardiovascular care
in diabetes in Spain.
Keywords
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Article info
Publication history
Published online: August 09, 2018
Accepted:
April 5,
2018
Received in revised form:
February 28,
2018
Received:
November 17,
2017
Identification
Copyright
© 2018 Published by Elsevier B.V. on behalf of European Federation of Internal Medicine.
