Background: To describe trends in the incidence and outcomes for atrial fibrillation (AF) in patients with and without type 2 diabetes (T2DM) in Spain between 2004 and 2013.
Methods: We used national hospital discharge data to select all patients discharged from hospital after AF. We focused our analysis on patients with AF in the primary diagnosis field. Discharges were grouped by diabetes status (diabetic or non-diabetic). Incidence was calculated overall and stratified by diabetes status. We analyzed diagnostic and therapeutic procedures, patient comorbidities, CHA2DS2-VASc score, length of hospital stay and in-hospital mortality (IHM).
Results: We identified a total of 214,457 admissions for AF (21.1% with T2DM). The incidence was higher among people with T2DM. Women with T2DM have significant higher incidence than men in all years studied. T2DM was positively associated with AF hospitalization (IRR 3.76, 95%CI 3.72-3.80). T2DM patients were significantly older than patients without diabetes, had more comorbidity and had higher values of CHA2DS2-VASc score. Prevalence of dyslipidemia and hypertension were almost 50% higher and prevalence of obesity was two times higher (all p values<0.05). Diabetes was not associated with a higher IHM (OR: 0.99, 95%CI 0.93-1.06). For the entire sample, time trend analyses showed a significant decrease in mortality in patients admitted for AF (OR: 0.98, 95%CI 0.97-0.99).
Conclusions: Incidence rates were higher in T2DM patients. Women with T2DM have significant higher incidence rates than men. The presence of diabetes is not associated with a higher IHM during admission for AF.
Keywords: Atrial fibrillation; Hospitalization; In-hospital mortality; Incidence; Length of stay; Type 2 diabetes mellitus.
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