The Impact of Diabetes on Mortality Among Elderly Patients Admitted for Treatment at a Hospital for Cardiovascular Disease in Southern Brazil.

Abstract

Diabetes has been shown to be associated with increased mortality and morbidity worldwide. This study explored whether diabetes significantly impacts on outcomes among elderly adults with cardiovascular disease (CVD) admitted to a specialist hospital in Southern Brazil. A prospective cohort study of 411 patients admitted to hospital after a cardiac event between 2008 and 2010. The primary end point was death by all causes during the follow up period of 6 months from admission. All hospital death reports matched those reported by the Brazilian Public Health Death Records. Cumulative probability of survival by Kaplan-Meier plot and log rank tests compared hospital admissions with or without diabetes. Adjusted and unadjusted hazard ratios (HR) for overall mortality were calculated. The mean ± SD age of the subjects was 69.8 years ± 14 and 50% were men. Overall study mortality was 8.7%. Half of the deaths occurred in patients ≥80 years (p=0.001). Diabetes was associated with 53% of the overall mortality (p<0.01) and 79% of the CVD-related deaths (p<0.03). The adjusted HR was 2.88 (95% CI 1.42-5.84) for diabetic patients aged ≥80 years. In conclusion, the results suggest that elderly patients of European origin with diabetes residing in Southern Brazil admitted to hospital for specialist CVD treatment have poorer survival and higher risk of further CVD events 6 months after hospital discharge compared with those without. We recommend that better strategies for managing CVD risk factors among elderly diabetic patients from similar patient cohorts in Brazil are necessary.