American journal of critical care : an official publication, American Association of Critical-Care Nurses · 2017
Heart Transplant Outcomes in Patients With Pretransplant Diabetes Mellitus.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Jalowiec Anne, Grady Kathleen L, White-Williams Connie
Аннотация
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.
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.