Original article
Analysis of hospitalizations by cardiovascular disease in the population with diabetes in SpainAnálisis de las hospitalizaciones por enfermedad cardiovascular en población diabética en España☆

https://doi.org/10.1016/j.rceng.2018.09.006Get rights and content

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.

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 30 días 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.

Section snippets

Background

Recent studies have indicated that the prevalence of diabetes mellitus (DM) in the adult Spanish population is 14%, with a trend toward doubling in the coming decades.1

There is evidence that patients with DM have a greater risk of hospitalization than patients without diabetes2, 3 and that the presence of diabetes is one of the main determinants of increased hospitalization costs, hospital readmissions and mortality.4

In Spain, the prevalence of DM in patients hospitalized in internal medicine

Materials and methods

In this study, we analyzed data from the minimum basic data set (MBDS) of patients discharged in 2015 from hospitals of the Spanish National Health System (NHS), provided by the Ministry of Health and Consumer Affairs, who were diagnosed with diabetes (ICD-9-CM: 250.xx). and is a database that must be filled in by the management of all hospital centers and sent annually to the Ministry of Health of their autonomous community and to the Ministry of Health and Consumer Affairs. The aim of the

Results

In 2015, 3,727,583 hospital discharges were registered in Spain, 619,188 (16.7%) of which corresponded to patients older than 18 years with DM.

The distribution by department is presented in Table 1. The internal medicine departments were responsible for 34.2% of the episodes (212,013), followed by cardiology (9.5%) and 3 surgical specialties: general surgery (8.9%), trauma (6.9%) and urology (4.8%).

The overall number of patients with DM hospitalized in internal medicine departments (34.2%) was

Discussion

The present study describes for the first time the hospital map for CVD in patients with DM in Spain and its distribution by department. It is worth noting that internal medicine departments treat more than a third of patients with DM hospitalized for any cause and more than 40% of hospitalized patients with DM and CVD. The patients hospitalized in internal medicine departments are older and have greater clinical complexity than those admitted to other medical or surgical departments.

It is also

Conflicts of interest

The authors declare that they have no conflicts of interest.

Acknowledgements

The authors would like to thank the Ministry of Health, Social Services and Equality for providing the MBDS.

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    • Cited by (0)

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    Please cite this article as: Zapatero-Gaviria A, Gómez-Huelgas R, Canora-Lebrato J, Ena-Muñoz J, Romero-Sánchez M, Mendez-Bailón M, et al. Análisis de las hospitalizaciones por enfermedad cardiovascular en población diabética en España. Rev Clin Esp. 2019;219:124–129.

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