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. 2011 Sep;124(9):834-40.
doi: 10.1016/j.amjmed.2011.04.030.

Weight and mortality following heart failure hospitalization among diabetic patients

Molly E Waring  1 , Jane S Saczynski, David McManus, Michael Zacharias, Darleen Lessard, Joel M Gore, Robert J Goldberg
Affiliations

Weight and mortality following heart failure hospitalization among diabetic patients

Molly E Waring et al. Am J Med. 2011 Sep.

Abstract

Background: Type 2 diabetes is an important risk factor for heart failure and is common among patients with heart failure. The impact of weight on prognosis after hospitalization for acute heart failure among patients with diabetes is unknown. The objective of this study was to examine all-cause mortality in relation to weight status among patients with type 2 diabetes hospitalized for decompensated heart failure.

Methods: The Worcester Heart Failure Study included adults admitted with acute heart failure to all metropolitan Worcester medical centers in 1995 and 2000. The weight status of 1644 patients with diabetes (history of type 2 diabetes in medical record or admission serum glucose ≥200 mg/dL) was categorized using body mass index calculated from height and weight at admission. Survival status was ascertained at 1 and 5 years after hospital admission.

Results: Sixty-five percent of patients were overweight or obese and 3% were underweight. Underweight patients had 50% higher odds of all-cause mortality within 5 years of hospitalization for acute heart failure than normal weight patients. Class I and II obesity were associated with 20% and 40% lower odds of dying. Overweight and Class III obesity were not associated with mortality. Results were similar for mortality within 1 year of hospitalization for acute heart failure.

Conclusions: The mechanisms underlying the association between weight status and mortality are not fully understood. Additional research is needed to explore the effects of body composition, recent weight changes, and prognosis after hospitalization for heart failure among patients with diabetes.

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Conflict of interest statement

None of the authors have conflicts of interest to disclose. All authors had access to the data and a role in writing the manuscript.

Figures

Figure
Figure
5-year mortality in relation to admission weight status*, among patients with diabetes hospitalized for heart failure * Underweight (18.5 kg/m2 < body mass index [BMI]), normal weight (18.5 kg/m2 ≤ BMI < 25 kg/m2), overweight (25 kg/m2 ≤ BMI < 30 kg/m2), Class I obesity (30 kg/m2 ≤ BMI < 35 kg/m2), Class II obesity (35 kg/m2 ≤ BMI < 40 kg/m2), and Class III obesity (40 kg/m2 ≤ BMI). Crude HRs (black) adjusted for study cohort. Multivariate-adjusted HRs (grey) adjusted for study cohort (1995 versus 2000), age (categorical), sex, DNR, GFR (continuous), length of stay (continuous), history of hypertension, history of COPD, history of PVD, history of PCI, history of CABG, and history of atrial fibrillation.
See this image and copyright information in PMC

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