title: Weight and mortality following heart failure hospitalization among diabetic patients.
abstract: BACKGROUND
  Type 2 diabetes is an important risk factor for heart failure and is common among patients with heart failure. The impact of weight on prognosis after hospitalization for acute heart failure among patients with diabetes is unknown. The objective of this study was to examine all-cause mortality in relation to weight status among patients with type 2 diabetes hospitalized for decompensated heart failure.
  
  
  METHODS
  The Worcester Heart Failure Study included adults admitted with acute heart failure to all metropolitan Worcester medical centers in 1995 and 2000. The weight status of 1644 patients with diabetes (history of type 2 diabetes in medical record or admission serum glucose ≥200 mg/dL) was categorized using body mass index calculated from height and weight at admission. Survival status was ascertained at 1 and 5 years after hospital admission.
  
  
  RESULTS
  Sixty-five percent of patients were overweight or obese and 3% were underweight. Underweight patients had 50% higher odds of all-cause mortality within 5 years of hospitalization for acute heart failure than normal weight patients. Class I and II obesity were associated with 20% and 40% lower odds of dying. Overweight and Class III obesity were not associated with mortality. Results were similar for mortality within 1 year of hospitalization for acute heart failure.
  
  
  CONCLUSIONS
  The mechanisms underlying the association between weight status and mortality are not fully understood. Additional research is needed to explore the effects of body composition, recent weight changes, and prognosis after hospitalization for heart failure among patients with diabetes.
authors.affiliation: Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA 01655, USA. molly.waring@umassmed.edu
authors.forename: Molly E
authors.initials: ME
authors.lastname: Waring
authors.forename: Jane S
authors.initials: JS
authors.lastname: Saczynski
authors.forename: David
authors.initials: D
authors.lastname: McManus
authors.forename: Michael
authors.initials: M
authors.lastname: Zacharias
authors.forename: Darleen
authors.initials: D
authors.lastname: Lessard
authors.forename: Joel M
authors.initials: JM
authors.lastname: Gore
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Goldberg
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D002423:Cause of Death; D048909:Diabetes Complications / Q000401:mortality*; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality*; D005260:Female; D006333:Heart Failure / Q000401:mortality*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D009765:Obesity / Q000401:mortality; D016017:Odds Ratio; D050177:Overweight / Q000401:mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D016019:Survival Analysis; D013851:Thinness / Q000401:mortality