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Geriatr Gerontol Int. 2018 Apr;18(4):554-560. doi: 10.1111/ggi.13215. Epub 2017 Nov 28.

Association between diabetes and mortality in elderly patients admitted for a first episode of acute heart failure.

Author information

1
Geriatric Unit, Internal Medicine Department, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
2
Hestia Chair in Integrated Health and Social Care, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.

Abstract

AIM:

To examine whether the presence of a prior diagnosis of diabetes mellitus (DM) influences mortality risk in elderly patients experiencing a first episode of heart failure (HF) hospitalization.

METHODS:

A total of 677 consecutive patients aged ≥75 years admitted for a first episode of acute decompensated heart failure were evaluated according to the presence or not of DM, and in-hospital and 1-year mortality rates were evaluated.

RESULTS:

A total of 240 patients (35.4%) had a diagnosis of DM. Overall, 42 patients (6.2%) died during admission; and 205 patients (30.3%) died after 1 year; however, no differences were observed in mortality rates between both groups. Cox univariate analysis did not identify prior DM diagnosis as a risk factor for 1-year mortality (HR 0.767, P < 0.082). Multivariate analysis identified older age (HR 1.101, P < 0.0001), lower preadmission Barthel Index (HR 0.987, P = 0.002), higher heart rate (HR 1.013, P = 0.02), higher admission serum potassium (HR 1.471, P = 0.016) and non-prescription of angiotensin-converting enzyme inhibitors or angiotensin II receptor antagonists (HR 1.597, P = 0.018) as independent risk factors for 1-year mortality.

CONCLUSIONS:

More than one-third of elderly patients experiencing a first admission because of acute heart failure decompensation had a prior diagnosis of DM. However, DM did not seem to be associated to a significant 1-year mortality risk. Geriatr Gerontol Int 2018; 18: 554-560.

KEYWORDS:

diabetes; heart failure; hospitalization; mortality

PMID:
29193694
DOI:
10.1111/ggi.13215
[Indexed for MEDLINE]

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