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Vol. 219. Issue 3.
Pages 107-170 (April 2019)
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Vol. 219. Issue 3.
Pages 107-170 (April 2019)
Original article
DOI: 10.1016/j.rceng.2018.09.006
Analysis of hospitalizations by cardiovascular disease in the population with diabetes in Spain
Análisis de las hospitalizaciones por enfermedad cardiovascular en población diabética en España
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A. Zapatero-Gaviriaa,
Corresponding author
, R. Gómez-Huelgasb, J. Canora-Lebratoa, J. Ena-Muñozc, M. Romero-Sáncheza, M. Mendez-Bailónd, J. Marco-Martínezd, R. Barba-Martíne
a Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
b Departamento de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, Spain
c Servicio de Medicina Interna, Hospital Marina Baixa, Villajoyosa, Alicante, Spain
d Servicio de Medicina Interna, Hospital Clínico Universitario San Carlos, Madrid, Spain
e Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
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Tables (4)
Table 1. Hospitalizations for patients with type 2 diabetes in Spain (2015). Distribution by department.
Table 2. Hospitalizations for patients with type 2 diabetes in Spain (2015). Descriptive analysis grouped by internal medicine departments and other medical and surgical departments.a
Table 3. Hospitalizations for patients with type 2 diabetes and cardiovascular disease in Spain (2015). Analysis grouped by internal medicine departments and other medical and surgical departments.
Table 4. Hospitalizations for patients with type 2 diabetes and cardiovascular disease in Spain (2015). Patient severity grade, according to APR-DRG.a
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Abstract
Objectives

Diabetes mellitus is associated with a marked increase in cardiovascular disease. In this study, we analyzed the prevalence of diabetes mellitus in hospitalised patients in Spain in 2015 and the burden of associated cardiovascular disease.

Methods

By analysing the 2015 minimum basic data set (MBDS) of the Spanish Ministry of Health, we included all patients discharged with a diagnosis of diabetes mellitus. We describe the epidemiological characteristics, distribution by the various hospital departments and the presence of cardiovascular disease.

Results

In 2015, there was 3,727,583 hospital discharges in Spain, 619,188 of which involved patients with diabetes (16.7%), 56.8% of whom were men and with a mean age of 73.2 years. The prevalence of cardiovascular disease was 40.8%, distributed among congestive heart failure (20.1%), cerebrovascular disease (10.3%), coronary artery disease (9.4%) and peripheral arterial disease (9.1%). Most of the patients were admitted to internal medicine (34.2%), cardiology (9.5%) and general surgery (8.9%) departments. The mean overall stay was 8.2 days, the readmission rate at 30 days was 14%, and the mortality rate was 6.8%. The patients hospitalized in internal medicine had higher severity levels (3–4) than those hospitalized in other medical departments (41.9% vs. 31.6%, respectively; p<.01) and those hospitalized in surgical departments (11.2%; p<.01).

Conclusions

Diabetes mellitus is a significant comorbidity for patients hospitalized in internal medicine. A significant proportion of these patients present cardiovascular disease, mostly heart failure.

Keywords:
Diabetes mellitus
Cardiovascular disease
Hospitalized patients
Internal medicine
Resumen
Objetivos

Diabetes mellitus se asocia con un marcado incremento de enfermedad cardiovascular. En el presente estudio analizamos la prevalencia de diabetes mellitus en pacientes hospitalizados en España en 2015 y la carga de enfermedad cardiovascular asociada.

Métodos

Mediante el análisis del conjunto mínimo básico de datos (CMBD) del Ministerio de Sanidad del año 2015, se incluyen todos los pacientes dados de alta con diagnóstico de diabetes mellitus. Se describen las características epidemiológicas, la distribución por los diferentes servicios hospitalarios y la presencia de enfermedad cardiovascular.

Resultados

En el año 2015 hubo 3.727.583 altas en España; de ellas, 619.188 correspondían a diabéticos (16,7%); el 56,8% eran varones y la edad media era de 73,2 años. La prevalencia de enfermedad cardiovascular fue del 40,8%, distribuida en insuficiencia cardiaca congestiva (20,1%), enfermedad cerebrovascular (10,3%), enfermedad coronaria (9,4%) y enfermedad arterial periférica (9,1%). La mayor parte de pacientes ingresaron en los servicios de medicina interna (34,2%), cardiología (9,5%) y cirugía general (8,9%). La estancia media global fue de 8,2 días y los reingresos a 30días alcanzaron el 14%. La mortalidad fue del 6,8%. Los pacientes ingresados en medicina interna tienen un grado de severidad más alto (3-4), 41,9% vs 31,6%, que los ingresados en otros servicios médicos (p<0,01) y que los ingresados en servicios quirúrgicos (11,2%) (p<0,01).

Conclusiones

La diabetes mellitus es una comorbilidad importante de los pacientes ingresados en medicina interna. Una proporción significativa de estos pacientes presenta enfermedad cardiovascular, y la más frecuente es la insuficiencia cardíaca.

Palabras clave:
Diabetes mellitus
Enfermedad cardiovascular
Hospitalizados
Medicina interna

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