Abstract 14687: Mortality Among Patients Hospitalized With Congestive Heart Failure and Diabetes Mellitus: Results From the National Inpatient Sample, 2000 - 2010

Abstract

Background: Case-fatality and hospitalization rates for heart failure (HF) patients have been steadily decreasing. However, the prevalence of diabetes mellitus (DM), a risk factor and frequent co-existing condition of HF, continues to increase in the general population. Our aims were to assess the prevalence and impact of DM among adult patients hospitalized with HF with particular emphasis on age-, sex- and race/ethnicity-specific in-hospital mortality rate. Methods: We used the National Inpatient Sample to estimate trends in DM prevalence and in-hospital mortality among hospital discharge records with HF as the primary discharge diagnosis from 2000-2010 using survey data-analysis methods. Multivariable logistic regression was used to assess the impact of the above demographic characteristics on in-hospital mortality while adjusting for time (year). Results: Overall mortality among 749,910 patients with HF declined from 4.0% in 2000 to 2.3% in 2010 (p<0.0001). Over this interval the prevalence of DM in HF patients increased from 35.9% to 37.5% (p < 0.0001). Age standardized mortality in this group (n=261,620) deceased from 3.2% in 2000 to 1.6% in 2010 (Figure). However, not all demographic sub-groups shared equally in this decrease. Males remained at increased risk compared to females (OR=1.069, 95% CI=0.96, 1.20), non-white minority patients remained at decreased risk compared to non-Hispanic whites (OR=0.612, 95% CI=0.54, 0.69) and older patients (≥ 60 years) remained at increased risk compared to their younger counterparts (< 60years) (OR=3.30, 95% CI=2.78, 3.92). Conclusions: In-hospital mortality among patients with HF and DM has significantly decreased over the past decade although important differences among demographic sub-groups remain and represent potential opportunities for further reduction in in-hospital mortality.