Trends in Diabetes-Related Potentially Preventable Hospitalizations in Adult Population in Spain, 1997⁻2015: A Nation-Wide Population-Based Study.

We aimed to assess national trends in the rates of diabetes-related potentially preventable hospitalizations (overall and by preventable condition) in the total adult population of Spain. We performed a population-based study of all adult patients with diabetes who were hospitalized from 1997 to 2015. Overall potentially preventable hospitalizations and hospitalizations by diabetes-related preventable conditions (short-term complications, long-term complications, uncontrolled diabetes, and lower-extremity amputations) were examined. Annual rates adjusted for age and sex were analyzed and trends were calculated. Over 19-years-period, 424,874 diabetes-related potentially preventable hospitalizations were recorded. Overall diabetes-related potentially preventable hospitalizations decreased significantly, with an average annual percentage change of 5.1 (95%CI: -5.6-(-4.7%); ptrend < 0.001). Among preventable conditions, the greatest decrease was observed in uncontrolled diabetes (-5.6%; 95%CI: -6.7-(-4.7%); ptrend < 0.001), followed by short-term complications (-5.4%; 95%CI: -6.1-(-4.9%); ptrend < 0.001), long-term complications (-4.6%; 95%CI: -5.1-(-3.9%); ptrend < 0.001), and lower-extremity amputations (-1.9%; 95%CI: -3.0-(-1.3%); ptrend < 0.001). These reductions were observed in all age strata for overall DM-related PPH and by preventable condition but lower-extremity amputations for those <65 years old. There was a greater reduction in overall DM-related PPH, uncontrolled DM, long-term-complications, and lower extremity amputations in females than in males (all p < 0.01). No significant difference was shown for short-term complications (p = 0.101). Our study shows a significant reduction in national trends for diabetes-related potentially preventable hospitalizations in Spain. These findings could suggest a sustained improvement in diabetes care in Spain, despite the burden of these diabetes-related complications and the increase in the diabetes mellitus prevalence.

National trends in diabetes mellitus hospitalization in Spain 1997-2010: Analysis of over 5.4 millions of admissions.

AIMS: To analyze national trends in the rates of hospitalizations (all-cause and by principal discharge diagnosis) in total diabetic population of Spain. METHODS: We carried out a nation-wide population-based study of all diabetic patients hospitalized between 1997 and 2010. All-cause hospitalizations, hospitalizations by principal discharge diagnosis, mean age, Charlson Comorbidity Index, readmission rates and length of hospital stay were examined. Annual rates adjusted for age and sex were analyzed and trends were calculated. RESULTS: Over 14-years-period, all-cause hospitalizations of diabetic patients increased significantly, with an average annual percentage change of 2.5 (95%CI: 1.5-3.5; Ptrend < 0.01). The greatest increase was observed in heart failure (5.4; 95%CI: 4.8-6.0; Ptrend < 0.001), followed by neoplasms (4.9; 95%CI: 3.6-5.8; Ptrend < 0.001), pneumonia (2.7; 95%CI: 2.0-4.0; Ptrend < 0.001), stroke (2.4; 95%CI: 1.6-3.4; Ptrend < 0.001), chronic obstructive pulmonary disease (2.0; 95%CI: 1.4-3.4; Ptrend < 0.001) and coronary artery disease (1.6; 95%CI: 1.1-2.3; Ptrend < 0.01). The adjusted number of all-cause hospitalizations of patients with diabetes per 100,000 inhabitants increased 2.6-fold. The increase in hospitalizations was significantly higher among patients ≥75 years old. Males experienced a greater increase in all-cause, neoplasm, heart failure, chronic obstructive pulmonary disease, and pneumonia hospitalizations (p < 0.01 for all). Hospitalized diabetic patients were progressively older and had more comorbidities, higher readmission rates and shorter hospital stays (p < 0.05 for all). CONCLUSIONS: Hospitalizations of diabetic patients more than doubled in Spain during the study period. Heart failure and neoplasms experienced the greatest annual increases and remained the principal causes of hospitalization, probably associated with advanced age and comorbidities of hospitalized diabetics. Coronary and cerebrovascular diseases experienced a lower annual increase, suggesting an improvement in cardiovascular care in diabetes in Spain.

Tendencias nacionales en hospitalización por insuficiencia cardiaca de pacientes con diabetes mellitus: periodo 1997-2010 / National trends in heart failure hospitalization rates in patients with diabetes mellitus: 1997-2010

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Familial aortic coarctation: a rare cause of refractory hypertension in the elderly: a case report.

We report the first case of late presentation of familial aortic coarctation, a rare cause of hypertension. Diagnosis of familial aortic coarctation in the elderly is exceptional, given that in the absence of endovascular or surgical repair patients do not usually survive beyond 50 years of age. Our case concerns a 72-year-old woman with hypertension of long evolution, control of which improved markedly after endovascular repair of the coarctation. Her son had undergone surgery for repair of aortic coarctation at the age of 23 years.