Type 2 Diabetes Is a Risk Factor for Suffering and for in-Hospital Mortality with Pulmonary Embolism. A Population-Based Study in Spain (2016–2018)

Abstract

(1) Background: The relationship between type 2 diabetes (T2DM) and pulmonary embolism (PE) has not been well stablished so far. We aim to analyze incidence, clinical conditions and in-hospital mortality (IHM) according to the presence of T2DM among patients hospitalized for suffering from PE. The factors associated with IHM were identified. (2) Methods: Patients aged ≥40 years hospitalized for PE from 2016 to 2018 included in the Spanish National Health System Hospital Discharge Database were analyzed. Dependent variables included incidence, IHM and length of hospital stay. Independent variables were age, sex, diagnosed comorbidities, thrombolytic therapy and inferior vena cava filter placement. Poisson and logistic regression models were constructed for multivariable analysis. (3) Results: Of the 47,190 hospitalizations for PE recorded, 16.52% had T2DM. Adjusted incidence of PE was higher among T2DM women (IRR 1.83; 95% CI: 1.58–1.96) and men (IRR 1.22; 95% CI: 1.18–1.27) than among non-diabetic subjects. Crude IHM in T2DM patients with PE was similar in both sexes but higher than in non-diabetic patients. Among T2DM patients with PE, risk factors for IHM included older age, comorbidity, atrial fibrillation and massive PE. Obesity was associated with lower IHM. Suffering T2DM was a risk of IHM (OR 1.15; 95% CI 1.05–1.26) after PE. (4) Conclusions: The incidence of PE is higher in T2DM men and women than in non-diabetic patients. T2DM was a risk factor for IHM after PE.

Diabetes mellitus and its impact on mortality rate and outcome in pulmonary embolism

“…In accordance with the present results, a recently published analysis of the Spanish National Health System Hospital Discharge Database in the timescale 2016-2018 comprising 47,190 patients aged ≥40 years who were hospitalized due to PE showed that diabetes was also associated with increased inhospital mortality (OR 1.15, 95% CI 1.05-1.26) 21 . These results from Spain (2016-2018) confirmed a former analysis comprising data of >120,000 PE patients in which diabetes was also related to higher in-hospital mortality (men OR 1.22, 95% CI 1.12-1.32; women OR 1.24, 95% CI 1.15-1.33) 47 .…”

“…Besides the association of diabetes with the development of VTE, diabetes is a well‐recognized important driver for cardiovascular morbidity and mortality 7 , 41 , 42 , 43 , 44 , 45 . Nevertheless, data on the impact of diabetes on mortality and other adverse outcomes of PE patients are sparse and contradictory 20 , 21 , 22 . Although, in accordance with the present results, the majority of studies showed an increased risk of adverse outcomes and especially mortality among PE patients with diabetes, other studies were not able to confirm this finding.…”

“…Besides the association of diabetes with the development of VTE, diabetes is a well-recognized important driver for cardiovascular morbidity and mortality 7,[41][42][43][44][45] . Nevertheless, data on the impact of diabetes on mortality and other adverse outcomes of PE patients are sparse and contradictory [20][21][22] .…”

“…In consequence, individuals with diabetes experience an elevated risk for arterial, as well as venous, thrombosis 18 , including the risk for PE 19 . Until today, data on the impact of diabetes on clinical outcome including mortality of PE patients is scarce, and the findings of available studies are controversial 20 , 21 , 22 .…”

Pulmonary embolism following the third thoracic tuberculosis surgery: A case report and literature review

“…It has also been reported that the incidence of pulmonary embolism was particularly high in type 2 diabetes patients. 26 The underlying mechanism in such cases might be the innate activation of hyperglycemia that leads to abnormal coagulation and impaired fibrinolysis and thus increasing the risk of thrombosis. 27,28 This case report presented a 74-year-old female patient with postoperative pulmonary embolism.…”