Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/19598
Title: Routine use of HbA1c amongst inpatients hospitalised with decompensated heart failure and the association of dysglycaemia with outcomes.
Authors: Khoo, Kaylyn;Lew, Jeremy F;Neef, Pieter A;Kearney, Leighton G;Churilov, Leonid;Robbins, Raymond J;Tan, Alanna;Hachem, M;Owen-Jones, L;Lam, Que T;Hart, Alanna;Wilson, A;Sumithran, Priya;Johnson, Douglas F;Srivastava, Piyush M;Farouque, Omar;Burrell, Louise M;Zajac, Jeffrey D;Ekinci, Elif I
Affiliation: Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Cardiology, Austin Health, Heidelberg, Victoria, Australia
The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
Department of Strategy, Quality & Service Redesign, Austin Health, Heidelberg, Victoria, Australia
Austin Centre for Applied Clinical Informatics, Austin Health, Heidelberg, Victoria, Australia
Department of Pathology, Austin Health, Heidelberg, Victoria, Australia
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Health and Biomedical Informatics Centre, University of Melbourne, Parkville, 3010, Victoria, Australia
St Vincent's Hospital Melbourne, Fitzroy, 3065, Victoria, Australia
Department of General Medicine, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 10-Sep-2018
EDate: 2018-09-10
Citation: Scientific reports 2018; 8(1): 13564
Abstract: Diabetes is an independent risk factor for development of heart failure and has been associated with poor outcomes in these patients. The prevalence of diabetes continues to rise. Using routine HbA1c measurements on inpatients at a tertiary hospital, we aimed to investigate the prevalence of diabetes amongst patients hospitalised with decompensated heart failure and the association of dysglycaemia with hospital outcomes and mortality. 1191 heart failure admissions were identified and of these, 49% had diabetes (HbA1c ≥ 6.5%) and 34% had pre-diabetes (HbA1c 5.7-6.4%). Using a multivariable analysis adjusting for age, Charlson comorbidity score (excluding diabetes and age) and estimated glomerular filtration rate, diabetes was not associated with length of stay (LOS), Intensive Care Unit (ICU) admission or 28-day readmission. However, diabetes was associated with a lower risk of 6-month mortality. This finding was also supported using HbA1c as a continuous variable. The diabetes group were more likely to have diastolic dysfunction and to be on evidence-based cardiac medications. These observational data are hypothesis generating and possible explanations include that more diabetic patients were on medications that have proven mortality benefit or prevent cardiac remodelling, such as renin-angiotensin system antagonists, which may modulate the severity of heart failure and its consequences.
URI: http://ahro.austin.org.au/austinjspui/handle/1/19598
DOI: 10.1038/s41598-018-31473-8
ORCID: 0000-0003-1863-7539
0000-0002-7143-7387
0000-0002-9807-6606
0000-0003-2372-395X
PubMed URL: 30202020
Type: Journal Article
Appears in Collections:Journal articles

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