Type 2 diabetes is associated with a higher incidence of hospitalization for pulmonary embolism in Spain: Analysis of hospital discharge data during 2004–2013

Miguel-Díez, Javier de; Muñoz‐Rivas, Nuria; Jiménez‐García, Rodrigo; Hernández-Barrera, Valentín; Carrasco‐Garrido, Pilar; Monréal, Manuel; Jiménez, David; Guijarro, Ricardo; Andrés, Ana López de

doi:10.1111/resp.12847

Cited by 16 publications

(11 citation statements)

References 42 publications

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“…11 33 34 The CMBD is periodically audited and the validity of the ‘diabetes diagnosis’ in hospital discharge reports has been demonstrated in the past 35–38. However, as a result of these audits, it is possible and desirable that accuracy of coding may have improved over time so this would affect the results of our investigation and must be taken into consideration.…”

Section: Discussionmentioning

confidence: 99%

Hospitalisation with community-acquired pneumonia among patients with type 2 diabetes: an observational population-based study in Spain from 2004 to 2013

et al. 2017

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ObjectivesTo describe trends in the incidence and outcomes of community-acquired pneumonia (CAP) hospitalisations among patients with or without diabetes in Spain (2004–2013).DesignRetrospective, observational study using the Spanish National Hospital Discharge Database (Conjunto Mínimo Básico de Datos (CMBD)).SettingSpain.ParticipantsWe used national hospital discharge data to select all hospital admissions for CAP.Main outcome measuresIncidence was calculated overall and stratified by diabetes status: type 2 diabetes mellitus (T2DM) and no diabetes.ResultsWe identified 901 136 admissions for CAP (24.8% with T2DM). Incidence rates of CAP increased significantly in patients with T2DM over time. The incidence was higher among people with T2DM for all time periods. Patients with T2DM were older and had higher comorbidity index than non-diabetics. Streptococcus pneumoniae decreased over time for both groups. Time trend analyses showed significant decreases in mortality during admission for CAP for patients with and without T2DM. Factors associated with higher mortality in both groups included: older age, higher comorbidity, mechanical ventilation, red cell transfusion, readmission and Staphylococcus aureus detection. Diabetes was associated with a lower in-hospital mortality (OR 0.92, 95% CI 0.91 to 0.94) after a CAP hospitalisation.ConclusionsCAP incidence rates were higher and increased over time at a higher rate among patients with T2DM. Mortality decreased over time in all groups. The presence of diabetes is not a risk factor for death during admission for CAP.

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Section: Discussionmentioning

confidence: 99%

Hospitalisation with community-acquired pneumonia among patients with type 2 diabetes: an observational population-based study in Spain from 2004 to 2013

et al. 2017

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“…However, there is limited and conflicting evidence regarding outcomes specifically in orthopedic patients. Some studies [7, 9, 10, 11] have reported a higher likelihood of poor outcomes among inpatients with diabetes, whilst others [12, 13] reported no increase in risk.…”

Section: Introductionmentioning

confidence: 99%

Using Automated HbA1c Testing to Detect Diabetes Mellitus in Orthopedic Inpatients and Its Effect on Outcomes

et al. 2017

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AimsThe prevalence of diabetes is rising, and people with diabetes have higher rates of musculoskeletal-related comorbidities. HbA1c testing is a superior option for diabetes diagnosis in the inpatient setting. This study aimed to (i) demonstrate the feasibility of routine HbA1c testing to detect the presence of diabetes mellitus, (ii) to determine the prevalence of diabetes in orthopedic inpatients and (iii) to assess the association between diabetes and hospital outcomes and post-operative complications in orthopedic inpatients.MethodsAll patients aged ≥54 years admitted to Austin Health between July 2013 and January 2014 had routine automated HbA1c measurements using automated clinical information systems (CERNER). Patients with HbA1c ≥6.5% were diagnosed with diabetes. Baseline demographic and clinical data were obtained from hospital records.ResultsOf the 416 orthopedic inpatients included in this study, 22% (n = 93) were known to have diabetes, 4% (n = 15) had previously unrecognized diabetes and 74% (n = 308) did not have diabetes. Patients with diabetes had significantly higher Charlson comorbidity scores compared to patients without diabetes (median, IQR; 1 [0,2] vs 0 [0,0], p<0.001). After adjusting for age, gender, comorbidity score and estimated glomerular filtration rate, no significant differences in the length of stay (IRR = 0.92; 95%CI: 0.79–1.07; p = 0.280), rates of intensive care unit admission (OR = 1.04; 95%CI: 0.42–2.60, p = 0.934), 6-month mortality (OR = 0.52; 95%CI: 0.17–1.60, p = 0.252), 6-month hospital readmission (OR = 0.93; 95%CI: 0.46–1.87; p = 0.828) or any post-operative complications (OR = 0.98; 95%CI: 0.53–1.80; p = 0.944) were observed between patients with and without diabetes.ConclusionsRoutine HbA1c measurement using CERNER allows for rapid identification of inpatients admitted with diabetes. More than one in four patients admitted to a tertiary hospital orthopedic ward have diabetes. No statistically significant differences in the rates of hospital outcomes and post-operative complications were identified between patients with and without diabetes.

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“…Our results document a significant increase in the number of comorbidities over time, consistent with findings of previous studies [ 14 , 28 ]. Among the comorbidities that significantly increased over time were hypertension, diabetes, obesity, cancer, and chronic kidney disease, some of which are known risk factors for PE [ 29 , 30 , 31 ]. Despite an increasing burden of comorbidities for PE patients, the LOHS improved over time in our study, as other authors have described [ 14 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Changing Trends in Hospital Admissions for Pulmonary Embolism in Spain from 2001 to 2018

Miguel‐Díez

Albaladejo-Vicente

López‐de‐Andrés

et al. 2020

JCM

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(1) Background: The aims of this study were to examine trends in the incidence, clinical characteristics, and in-hospital outcomes of patients hospitalized with pulmonary embolism in Spain and to identify factors associated with in-hospital mortality (IHM). (2) Methods: We included all patients who were hospitalized for pulmonary embolism between 2001 and 2018. Data were collected from the Spanish National Hospital Discharge Database. (3) Results: We identified 241,821 hospitalizations for pulmonary embolism during the study period. The incidence of pulmonary embolism increased from 20.49 cases per 100,000 inhabitants in the period 2001–2002 to 35.9 cases in the period 2017–2018 (p < 0.001). After controlling for possible confounders, there was a significant increase in the incidence over the study period (adjusted incidence rate ratio 1.53, 95% Confidence Interval I 1.51–1.56). The median length of hospital stay was 11 days in the period 2001–2002, decreasing to seven days in the period 2017–2018 (p < 0.001). For the total time period, the crude IHM rate was 9.51%. After multivariable adjustment, IHM decreased significantly over time. The IHM was significantly higher in women, in patients suffering from more comorbidities, and in those with a massive pulmonary embolism. (4) Conclusions: Our results revealed an increase in the incidence of pulmonary embolism hospitalizations from 2001 to 2018 in Spain, with older patients being the most affected.

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Type 2 diabetes is associated with a higher incidence of hospitalization for pulmonary embolism in Spain: Analysis of hospital discharge data during 2004–2013

Cited by 16 publications

References 42 publications

Hospitalisation with community-acquired pneumonia among patients with type 2 diabetes: an observational population-based study in Spain from 2004 to 2013

Hospitalisation with community-acquired pneumonia among patients with type 2 diabetes: an observational population-based study in Spain from 2004 to 2013

Using Automated HbA1c Testing to Detect Diabetes Mellitus in Orthopedic Inpatients and Its Effect on Outcomes

Changing Trends in Hospital Admissions for Pulmonary Embolism in Spain from 2001 to 2018

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