title: Hospitalizations from pandemic Influenza [A(H1N1)pdm09] infections among type 1 and 2 diabetes patients in Spain.
abstract: OBJECTIVE
  To describe and analyze the clinical characteristics and outcomes for all patients with diabetes who were hospitalized with laboratory-confirmed A(H1N1)pdm09 infections in Spain during 2009.
  
  
  METHODS
  Observational retrospective study using data collected by the Spanish National Hospital Discharge Database. We selected all admissions with diagnosis ICD-9-CM code 488·1 [A(H1N1)pdm09]. Discharges were grouped as follows: no diabetes, Type1 and Type 2 diabetes. Underlying medical conditions and risk factors included all those that constitute an indication for annual influenza vaccination, pregnancy, and obesity. The outcome variables analyzed were in-hospital case fatality risk, length of hospital stay, and costs.
  
  
  RESULTS
  The total number of persons hospitalized with A(H1N1)pdm09 was 11,499. Of those, 97 suffered Type 1 and 936 Type 2, giving an overall prevalence of diabetes of 9%. The most common underlying medical condition among Type 2 subjects was obesity (26·8%), and for Type 1 renal disease (10·3%). In-hospital mortality was 2·1% among Type 1 patients, 3·8% among Type 2 patients, and 2·3% among non-diabetics; after multivariate analysis, diabetes was not a factor independently associated with dying during hospitalization for A(H1N1)pdm09. Independent factors increasing the risk of death among diabetic patients included age (OR 1·03; 95% CI1·01-1·05), hematological disorders (OR 3·49; 95% CI, 1·46-8·37), and obesity (OR 1·88; 95% CI1·07-3·92).
  
  
  CONCLUSIONS
  Among individuals hospitalized in Spain with A(H1N1)pdm09 infections, the age-specific prevalence of diabetes was higher than the general population in most age groups. The results of multivariate analysis suggest that possibly concomitant conditions such as obesity increase the risk of dying from the infection, but not diabetes itself.
authors.affiliation: Preventive Medicine Unit, Rey Juan Carlos University, Madrid, Spain. rodrigo.jimenez@urjc.es
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Jiménez-García
authors.forename: Valentín
authors.initials: V
authors.lastname: Hernández-Barrera
authors.forename: Cristina
authors.initials: C
authors.lastname: Rodríguez-Rieiro
authors.forename: Ana
authors.initials: A
authors.lastname: Lopez de Andres
authors.forename: Javier
authors.initials: J
authors.lastname: de Miguel-Diez
authors.forename: Isabel
authors.initials: I
authors.lastname: Jimenez-Trujillo
authors.forename: Angel
authors.initials: A
authors.lastname: Gil de Miguel
authors.forename: Pilar
authors.initials: P
authors.lastname: Carrasco-Garrido
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology* / Q000401:mortality / Q000821:virology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology* / Q000401:mortality / Q000821:virology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000235:genetics / Q000302:isolation & purification* / Q000502:physiology; D007251:Influenza, Human / Q000150:complications / Q000453:epidemiology* / Q000401:mortality / Q000821:virology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D058873:Pandemics; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D055815:Young Adult