title: Impact of type 2 diabetes mellitus in hospitalizations for atrial fibrillation in Spain (2004-2013).
abstract: 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.
authors.affiliation: Medicine Department, Hospital Clínico San Carlos, Madrid, Comunidad de Madrid, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Méndez-Bailón
authors.affiliation: Medicine Department, Hospital Universitario Infanta Leonor, Madrid, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Muñoz-Rivas
authors.affiliation: Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcon, Comunidad de Madrid, Spain. Electronic address: rodrigo.jimenez@urjc.es.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Jiménez-García
authors.affiliation: Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcon, Comunidad de Madrid, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Esteban-Hernández
authors.affiliation: Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcon, Comunidad de Madrid, Spain.
authors.forename: Valentín
authors.initials: V
authors.lastname: Hernández-Barrera
authors.affiliation: Medicine Department, Hospital Gregorio Marañon, Comunidad de Madrid, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: de Miguel-Yanes
authors.affiliation: Medicine Department, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas, Gran Canaria, Spain.
authors.forename: Noel
authors.initials: N
authors.lastname: Lorenzo-Villalba
authors.affiliation: Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcon, Comunidad de Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Lopez-de-Andrés
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
keywords: Atrial fibrillation; Hospitalization; In-hospital mortality; Incidence; Length of stay; Type 2 diabetes mellitus