Abstract
Background Findings on outcomes of heart transplant patients who had diabetes mellitus before transplant are conflicting. Objective To compare survival, hospitalization, and complications in heart transplant recipients during the first 3 years after surgery in recipients with or without diabetes mellitus before transplant. Methods Of 347 recipients, 64 were diabetic (35.9% taking insulin; mean age 56 years; 17.2% females; 12.5% minorities) and 283 were not (mean age 51 years; 20.8% females; 15.2% minorities). Outcomes examined were length of survival, number of days hospitalized (including transplant admission), acute graft rejection, infection, cardiac allograft vasculopathy, stroke, cancer, and renal dysfunction. Results Patients with pretransplant diabetes spent significantly more time in the hospital during the first 3 years after transplant than did patients without preexisting diabetes (P = .01). Compared with nondiabetic patients, diabetic patients were hospitalized more often for infections and complications related to the cardiovascular, gastrointestinal, respiratory, renal, hematologic, and neurological systems. The 2 groups did not differ significantly in length of survival or in rates of rejection, infection, cardiac allograft vasculopathy, stroke, cancer, or renal dysfunction. Conclusions Heart transplant recipients with pretransplant diabetes fared just as well as patients without pretransplant diabetes in 7 of the 8 outcomes examined, except for the number of days hospitalized during the first 3 years after heart transplant. This study provides clinically important new information on the greater hospitalization time and the reasons for hospitalization during the first 3 years after heart transplant in patients with pretransplant diabetes.
Original language | English (US) |
---|---|
Pages (from-to) | 482-490 |
Number of pages | 9 |
Journal | American Journal of Critical Care |
Volume | 26 |
Issue number | 6 |
DOIs | |
State | Published - 2017 |
Funding
FINANCIAL DISCLOSURES Funding was provided by grants NR01693, NR01693/S, and 5R01-NR01693, National Institute of Nursing Research; grant HL49336, National Heart, Lung, and Blood Institute; Sandoz Pharmaceuticals Corporation; Earl Bane Estate; American Association of Critical-Care Nurses; Sigma Theta Tau; Loyola University Research Committee; Loyola University School of Nursing; and Loyola University Medical Center. We used the clinical data from the existing database of a 10-year prospective, longitudinal study funded by the National Institutes of Health and conducted at 2 US hospitals. The focus of that study was the impact of medical, physical, and psychosocial factors on multiple HT outcomes over time; data were collected from medical records and from patient-completed questionnaires on quality of life (eg, symptoms, functional ability, stressors, coping, social support resources).28-37 The long-term study was approved by the institutional review board at each site, and patients provided written informed consent.
ASJC Scopus subject areas
- Critical Care