Mortality and Cardiovascular Complications in Older Complex Chronic Patients with Type 2 Diabetes

J L Clua-Espuny, M A González-Henares, M L L Queralt-Tomas, W Campo-Tamayo, E Muria-Subirats, A Panisello-Tafalla, J Lucas-Noll, J L Clua-Espuny, M A González-Henares, M L L Queralt-Tomas, W Campo-Tamayo, E Muria-Subirats, A Panisello-Tafalla, J Lucas-Noll

Abstract

Aims/introduction: Determining the prevalence of diabetes and its cardiovascular complications and all-cause mortality in older chronic complex patients.

Materials and methods: We carried out a multicenter retrospective study and included a randomized sample of 932 CCP people. We assessed the prevalence of diabetes according to World Health Organization criteria. Data included demographics and functional, comorbidity, cognitive, and social assessment.

Results: The prevalence of diabetes was 53% and average age 81.16 ± 8.93 years. There were no significant differences in the survival of CCP patients with or without DM, with or without ischaemic cardiopathy, and with or without peripheral vascular disease. The prognostic factors of all-cause mortality in patients with DM were age ≥ 80 years [HR 1.47, 95% CI 1.02-2.13, p 0.038], presence of heart failure [HR 1.73, 95% CI 1.25-2.38, p 0.001], Charlson score [HR 1.20, 95% CI 1.06-1.36, p 0.003], presence of cognitive impairment [HR 1.73, 95% CI 1.24-2.40, p 0.001], and no treatment with statins [HR 1.49, 95% CI 1.08-2.04, p 0.038].

Conclusions: We found high prevalence of DM among CCP patients and the relative importance of traditional risk factors seemed to wane with advancing age. Recommendations may include relaxing treatment goals, providing family/patient education, and enhanced communication strategies.

Figures

Figure 1
Figure 1
Kaplan-Meier estimates of survival during follow-up in CCP with or without diabetes mellitus at baseline.
Figure 2
Figure 2
Kaplan-Meier estimates of survival during follow-up in CCP with or without ischaemic cardiopathy at baseline.
Figure 3
Figure 3
Kaplan-Meier estimates of survival during follow-up in CCP with or without atrial fibrillation at baseline.
Figure 4
Figure 4
Kaplan-Meier estimates of survival during follow-up in CCP with and without heart failure at baseline.

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