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.
Keywords
Abbreviations:
APC (annual percentage of change), CCI (Charlson comorbidity index), COPD (chronic obstructive pulmonary disease), DRG (Diagnosis-Related Groups), ER (emergency room), ICD-9-CM (International Classification Disease-9-Clinical Modification), IHM (in-hospital mortality), IRR (Incidence Rate Ratio), HF (heart failure), LOHS (length of hospital stay), OR (Odds Ratio), SNHDD (Spanish National Hospital Discharge Database), T2DM (type 2 diabetes)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 22, 2018
Accepted:
August 15,
2018
Received in revised form:
July 24,
2018
Received:
June 6,
2018
Identification
Copyright
© 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
