Influence of diabetes and other risk factors on in-hospital mortality following kidney transplantation: an analysis of the Spanish National Hospital Discharge Database from 2016 to 2020

IF 3.7 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

BMJ Open Diabetes Research & Care Pub Date : 2024-03-01 DOI:10.1136/bmjdrc-2023-003799

Ana Lopez-de-Andres, Rodrigo Jimenez-Garcia, Marta Lopez-Herranz, José Javier Zamorano-Leon, David Carabantes-Alarcon, Valentin Hernandez-Barrera, Javier de Miguel-Diez, Francisco Carricondo, Barbara Romero-Gomez, Natividad Cuadrado-Corrales

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引用次数: 0

Abstract

Introduction To assess time trends in incidence, clinical characteristics, complications, and hospital outcomes among patients with type 1 diabetes (T1D), with type 2 diabetes (T2D), and patients without diabetes who underwent kidney transplant (KT); to identify variables associated with in-hospital mortality (IHM); and to determine the impact of the COVID-19 pandemic. Research design and methods We used a nationwide discharge database to select KT recipients admitted to Spanish hospitals from 2016 to 2020. We stratified patients according to diabetes status. We used multivariable logistic regression to identify the variables associated with IHM. Results A total of 14 594 KTs were performed in Spain (T2D, 22.28%; T1D, 3.72%). The number of KTs rose between 2016 and 2019 and and decreased from 2019 to 2020 in all groups. In patients with T2D, the frequency of KT complications increased from 21.08% in 2016 to 34.17% in 2020 (p<0.001). Patients with T2D had significantly more comorbidity than patients with T1D and patients without diabetes (p<0.001). Patients with T1D experienced KT rejection significantly more frequently (8.09%) than patients with T2D (5.57%). COVID-19 was recorded in 26 out of the 2444 KTs performed in 2020, being found in 6 of the 39 patients deceased that year (15.38%) and in 0.83% of the survivors. The variables associated with IHM were comorbidity and complications of KT. The presence of T1D was associated with IHM (OR 2.6; 95% CI 1.36 to 5.16) when patients without diabetes were the reference category. However, T2D was not associated with a higher IHM (OR 0.86; 95% CI 0.61 to 1.2). Conclusions The COVID-19 pandemic led to a decrease in the number of transplants. Patients with T1D have more rejection of the transplanted organ than patients with T2D. Fewer women with T2D undergo KT. The presence of T1D is a risk factor for IHM. Data may be obtained from a third party and are not publicly available.

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糖尿病和其他风险因素对肾移植术后院内死亡率的影响：2016 年至 2020 年西班牙国家医院出院数据库分析

简介：目的评估接受肾移植（KT）的 1 型糖尿病（T1D）患者、2 型糖尿病（T2D）患者和非糖尿病患者的发病率、临床特征、并发症和住院预后的时间趋势；确定与院内死亡率（IHM）相关的变量；并确定 COVID-19 大流行的影响。研究设计与方法我们利用全国性出院数据库，选择了 2016 年至 2020 年期间在西班牙医院住院的 KT 受者。我们根据糖尿病状态对患者进行了分层。我们使用多变量逻辑回归来确定与 IHM 相关的变量。结果西班牙共进行了 14 594 例 KT（T2D，22.28%；T1D，3.72%）。2016 年至 2019 年期间，所有组别的 KT 数量均有所上升，2019 年至 2020 年期间则有所下降。在T2D患者中，KT并发症的发生率从2016年的21.08%上升到2020年的34.17%（P<0.001）。T2D患者的合并症明显多于T1D患者和非糖尿病患者（p<0.001）。T1D 患者发生 KT 排斥的比例（8.09%）明显高于 T2D 患者（5.57%）。在 2020 年进行的 2444 例 KT 中，有 26 例记录到 COVID-19，在当年死亡的 39 例患者中，有 6 例（15.38%）和 0.83% 的幸存者中发现了 COVID-19。与 IHM 相关的变量是合并症和 KT 并发症。以无糖尿病患者为参照类别时，T1D 的存在与 IHM 相关（OR 2.6；95% CI 1.36 至 5.16）。然而，T2D 与较高的 IHM 无关（OR 0.86；95% CI 0.61 至 1.2）。结论 COVID-19 大流行导致移植数量减少。与 T2D 患者相比，T1D 患者对移植器官的排斥反应更严重。接受 KT 的 T2D 女性患者较少。T1D 患者是 IHM 的危险因素。数据可能来自第三方，不对外公开。

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来源期刊

BMJ Open Diabetes Research & Care Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

9.30

自引率

2.40%

发文量

123

审稿时长

18 weeks

期刊介绍： BMJ Open Diabetes Research & Care is an open access journal committed to publishing high-quality, basic and clinical research articles regarding type 1 and type 2 diabetes, and associated complications. Only original content will be accepted, and submissions are subject to rigorous peer review to ensure the publication of high-quality — and evidence-based — original research articles.