title: A four-year cardiovascular risk score for type 2 diabetic inpatients.
abstract: As cardiovascular risk tables currently in use were constructed using data from the general population, the cardiovascular risk of patients admitted via the hospital emergency department may be underestimated. Accordingly, we constructed a predictive model for the appearance of cardiovascular diseases in patients with type 2 diabetes admitted via the emergency department. We undertook a four-year follow-up of a cohort of 112 adult patients with type 2 diabetes admitted via the emergency department for any cause except patients admitted with acute myocardial infarction, stroke, cancer, or a palliative status. The sample was selected randomly between 2010 and 2012. The primary outcome was time to cardiovascular disease. Other variables (at baseline) were gender, age, heart failure, renal failure, depression, asthma/chronic obstructive pulmonary disease, hypertension, dyslipidaemia, insulin, smoking, admission for cardiovascular causes, pills per day, walking habit, fasting blood glucose and creatinine. A cardiovascular risk table was constructed based on the score to estimate the likelihood of cardiovascular disease. Risk groups were established and the c-statistic was calculated. Over a mean follow-up of 2.31 years, 39 patients had cardiovascular disease (34.8%, 95% CI [26.0-43.6%]). Predictive factors were gender, age, hypertension, renal failure, insulin, admission due to cardiovascular reasons and walking habit. The c-statistic was 0.734 (standard error: 0.049). After validation, this study will provide a tool for the primary health care services to enable the short-term prediction of cardiovascular disease after hospital discharge in patients with type 2 diabetes admitted via the emergency department.
authors.affiliation: Research Unit, Elda Hospital , Elda, Alicante , Spain ; Department of Clinical Medicine, Miguel Hernández University , San Juan de Alicante, Alicante , Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Ramírez-Prado
authors.affiliation: Research Unit, Elda Hospital , Elda, Alicante , Spain ; Department of Clinical Medicine, Miguel Hernández University , San Juan de Alicante, Alicante , Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Palazón-Bru
authors.affiliation: Department of Clinical Medicine, Miguel Hernández University , San Juan de Alicante, Alicante , Spain.
authors.forename: David Manuel
authors.initials: DM
authors.lastname: Folgado-de la Rosa
authors.affiliation: Emergencies Unit, Elda Hospital , Elda, Alicante , Spain.
authors.forename: María Ángeles
authors.initials: MÁ
authors.lastname: Carbonell-Torregrosa
authors.affiliation: Emergencies Unit, Elda Hospital , Elda, Alicante , Spain.
authors.forename: Ana María
authors.initials: AM
authors.lastname: Martínez-Díaz
authors.affiliation: Department of Clinical Medicine, Miguel Hernández University , San Juan de Alicante, Alicante , Spain.
authors.forename: Damian Robert James
authors.initials: DR
authors.lastname: Martínez-St John
authors.affiliation: Research Unit, Elda Hospital , Elda, Alicante , Spain ; Department of Clinical Medicine, Miguel Hernández University , San Juan de Alicante, Alicante , Spain.
authors.forename: Vicente Francisco
authors.initials: VF
authors.lastname: Gil-Guillén
keywords: Cardiovascular diseases; Diabetes mellitus; Emergencies; Predictive models; Primary Health Care