Diabetes mellitus was independently associated with a significantly increased risk of in-hospital mortality (OR 1.21) in patients hospitalized with acute pulmonary embolism compared to those without diabetes.
Observational (n=1,174,196)
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Does diabetes mellitus increase in-hospital mortality and adverse events in patients hospitalized with pulmonary embolism?
Diabetes mellitus, particularly type 1, is an independent risk factor for increased in-hospital mortality and adverse events in patients with acute pulmonary embolism.
Odds Ratio: 1.21 (95% CI 1.2–1.23)
Tasa de eventos absoluta: 19.8% vs 14.8%
valor p: p=<0.001
AIMS/INTRODUCTION: In patients with pulmonary embolism (PE), the impact of diabetes mellitus on patient profile and outcome is not well investigated. MATERIAL AND METHODS: The German nationwide inpatient sample of the years 2005-2018 was analyzed. Hospitalized PE patients were stratified for diabetes, and the impact of diabetes on in-hospital events was investigated. RESULTS: Overall, 1,174,196 PE patients (53.8% aged ≥70 years, 53.5% women) and, among these, 219,550 (18.7%) diabetes patients were included. In-hospital mortality rate amounted to 15.8%, and was higher in diabetes patients than in non-diabetes patients (19.8% vs 14.8%, P < 0.001). PE patients with diabetes had a higher prevalence of cardiovascular risk factors, comorbidities, right ventricular dysfunction (31.8% vs 27.7%, P < 0.001), prolonged in-hospital stay (11.0 vs 9.0 days, P < 0.001) and higher rates of adverse in-hospital events. Remarkably, diabetes was independently associated with increased in-hospital mortality (odds ratio OR 1.21, 95% confidence interval CI 1.20-1.23, P < 0.001) when adjusted for age, sex and comorbidities. Within the observation period of 2005-2018, a relevant decrease of in-hospital mortality in PE patients with diabetes was observed (25.5% to 16.8%). Systemic thrombolysis was more often administered to diabetes patients (OR 1.18, 95% CI 1.01-3.49, P < 0.001), and diabetes was associated with intracerebral (OR 1.19, 95% CI 1.12-1.26, P < 0.001), as well as gastrointestinal bleeding (OR 1.11, 95% CI 1.07-1.15, P < 0.001). Type 1 diabetes mellitus was shown to be a strong risk factor in PE patients for shock, right ventricular dysfunction, cardiopulmonary resuscitation and in-hospital death (OR 1.75, 95% CI 1.61-1.90, P < 0.001). CONCLUSIONS: Despite the progress in diabetes treatments, diabetes is still associated with an unfavorable clinical patient profile and higher risk for adverse events, including substantially increased in-hospital mortality in acute PE.
Schmitt et al. (Mon,) conducted a observational in Pulmonary embolism (n=1,174,196). Diabetes mellitus vs. No diabetes mellitus was evaluated on In-hospital mortality (OR 1.21, 95% CI 1.20-1.23, p=<0.001). Diabetes mellitus was independently associated with a significantly increased risk of in-hospital mortality (OR 1.21) in patients hospitalized with acute pulmonary embolism compared to those without diabetes.