title: Mortality Among Patients Hospitalized With Heart Failure and Diabetes Mellitus: Results From the National Inpatient Sample 2000 to 2010.
abstract: Case fatality and hospitalization rates for US patients with heart failure (HF) have steadily decreased during the past several decades. Diabetes mellitus (DM), a risk factor for, and frequent coexisting condition with, HF continues to increase in the general population.
  
  
  
  We used the National Inpatient Sample to estimate overall as well as age-, sex-, and race/ethnicity-specific trends in HF hospitalizations, DM prevalence, and in-hospital mortality among 2.5 million discharge records from 2000 to 2010 with HF as primary discharge diagnosis. Multivariable logistic and Poisson regression were used to assess the impact of the above demographic characteristics on in-hospital mortality. Age-standardized hospitalizations decreased significantly in HF overall and in HF with DM. Age-standardized in-hospital mortality with HF declined from 2000 to 2010 (4.57% to 3.09%, Ptrend<0.0001), whereas DM prevalence in HF increased (38.9% to 41.9%, Ptrend<0.0001) as did comorbidity burden. Age-standardized in-hospital mortality in HF with DM also decreased significantly (3.53% to 2.27%, Ptrend<0.0001). After adjusting for year, age, and comorbid burden, males remained at 17% increased risk versus females, non-Hispanics remained at 12% increased risk versus Hispanics, and whites had a 30% higher mortality versus non-white minorities. Absolute mortality rates were lower in younger versus older patients, although the rate of decline was attenuated in younger patients.
  
  
  
  In-hospital mortality in HF patients with DM significantly decreased during the past decade, despite increases in DM prevalence and comorbid conditions. Mortality rate decreases among younger patients were significantly attenuated, and mortality disparities remain among important demographic subgroups.
authors.affiliation: From the Divisions of Cardiology (T.T.W., W.K.L.) and Epidemiology, Biostatistics, and Preventive Medicine (H.T.D., W.K.L.), Department of Medicine, University of New Mexico School of Medicine, Albuquerque.
authors.forename: Theingi Tiffany
authors.initials: TT
authors.lastname: Win
authors.affiliation: From the Divisions of Cardiology (T.T.W., W.K.L.) and Epidemiology, Biostatistics, and Preventive Medicine (H.T.D., W.K.L.), Department of Medicine, University of New Mexico School of Medicine, Albuquerque.
authors.forename: Herbert T
authors.initials: HT
authors.lastname: Davis
authors.affiliation: From the Divisions of Cardiology (T.T.W., W.K.L.) and Epidemiology, Biostatistics, and Preventive Medicine (H.T.D., W.K.L.), Department of Medicine, University of New Mexico School of Medicine, Albuquerque. wlaskey@salud.unm.edu.
authors.forename: Warren K
authors.initials: WK
authors.lastname: Laskey
mesh_terms: D001741:Black or African American; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian; D016009:Chi-Square Distribution; D015897:Comorbidity; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality* / Q000628:therapy; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality* / Q000628:therapy; D006630:Hispanic or Latino; D017052:Hospital Mortality / Q000208:ethnology / Q000639:trends*; D006760:Hospitalization; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D044465:White People
keywords: diabetes mellitus; heart failure; hospitalization; mortality; risk factor