Longitudinal assessment of the impact of prevalent diabetes on hospital admissions and mortality in the general population: a prospective population-based study with 19 years of follow-up
Johansson, Madeleine LU
; Åkesson, Anna
; Nilsson, Peter M.
LU
and Melander, Olle
LU
(2024)
In BMC Public Health
24.
p.1-11
- Abstract
- Background
Hospitalization indicates the presence of severe disease and constitutes a leading cost in health care. We aimed to prospectively assess if prevalent diabetes mellitus contributes to excess all-cause and cause-specific hospital admissions and mortality at the population level.
Methods
We used a Swedish prospective population-based cohort, including 25,642 individuals of whom 4.2% had prevalent diabetes at baseline (mean age 61.2 ± 6.8 years, age range 44.8–73.4 years). We compared the number of hospitalizations and mortality classified according to the main chapters of the 10th revision of the International Classification of Diseases (ICD-10) during follow-up using nationwide inpatient registries, comparing... (More) - Background
Hospitalization indicates the presence of severe disease and constitutes a leading cost in health care. We aimed to prospectively assess if prevalent diabetes mellitus contributes to excess all-cause and cause-specific hospital admissions and mortality at the population level.
Methods
We used a Swedish prospective population-based cohort, including 25,642 individuals of whom 4.2% had prevalent diabetes at baseline (mean age 61.2 ± 6.8 years, age range 44.8–73.4 years). We compared the number of hospitalizations and mortality classified according to the main chapters of the 10th revision of the International Classification of Diseases (ICD-10) during follow-up using nationwide inpatient registries, comparing individuals with and without prevalent diabetes, using multivariate adjusted negative binomial regression (incidence rate ratio, IRR) and Cox regression, respectively.
Results
During a median follow-up of 19 years, 18,904 subjects were hospitalized at least once [median 3 (IQR 2–6)] and 6767 (26.4%) individuals died. Overall, subjects with diabetes were hospitalized (IRR 1.83, p < 0.001) more often, and had a higher incidence rate of hospital admissions due to endocrine diseases (IRR 14.6, p < 0.001), dermatological diseases (IRR 3.7, p < 0.001), injuries and poisoning (IRR 2.7, p < 0.001), infectious diseases (IRR 2.5, p < 0.001), psychiatric diseases (IRR 2.0, p < 0.001), but also cardiovascular, hematological, genitourinary, neurologic and respiratory diseases compared with non-diabetic individuals. No difference was observed for hospital admissions due to cancer or musculoskeletal disorders. All-cause mortality was higher (HR 1.77, p < 0.001) in individuals with diabetes, with disease-specific mortality being significant only for cardiovascular and endocrine disease-related death.
Conclusions
At the population level, prevalent diabetes increased the hospitalization burden longitudinally due to diseases of most of the ICD-10 main chapters, except for cancer and musculoskeletal disorders. These novel findings challenge the current view on the spectrum of prevalent diabetes-related conditions and may have implications for screening and treatment strategies in diabetes. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/550e8bf2-df1d-424d-baf7-9ed044cc7d60
- author
- Johansson, Madeleine
LU
; Åkesson, Anna
; Nilsson, Peter M.
LU
and Melander, Olle
LU
- organization
- publishing date
- 2024-10-24
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- hospitalisation, diabetes mellitus
- in
- BMC Public Health
- volume
- 24
- article number
- 2948
- pages
- 1 - 11
- publisher
- BioMed Central (BMC)
- external identifiers
-
- scopus:85207335837
- pmid:39448967
- ISSN
- 1471-2458
- DOI
- 10.1186/s12889-024-20435-7
- language
- English
- LU publication?
- yes
- id
- 550e8bf2-df1d-424d-baf7-9ed044cc7d60
- date added to LUP
- 2024-10-24 16:19:24
- date last changed
- 2025-06-25 02:57:17
@article{550e8bf2-df1d-424d-baf7-9ed044cc7d60,
abstract = {{Background<br/>Hospitalization indicates the presence of severe disease and constitutes a leading cost in health care. We aimed to prospectively assess if prevalent diabetes mellitus contributes to excess all-cause and cause-specific hospital admissions and mortality at the population level.<br/><br/>Methods<br/>We used a Swedish prospective population-based cohort, including 25,642 individuals of whom 4.2% had prevalent diabetes at baseline (mean age 61.2 ± 6.8 years, age range 44.8–73.4 years). We compared the number of hospitalizations and mortality classified according to the main chapters of the 10th revision of the International Classification of Diseases (ICD-10) during follow-up using nationwide inpatient registries, comparing individuals with and without prevalent diabetes, using multivariate adjusted negative binomial regression (incidence rate ratio, IRR) and Cox regression, respectively.<br/><br/>Results<br/>During a median follow-up of 19 years, 18,904 subjects were hospitalized at least once [median 3 (IQR 2–6)] and 6767 (26.4%) individuals died. Overall, subjects with diabetes were hospitalized (IRR 1.83, p < 0.001) more often, and had a higher incidence rate of hospital admissions due to endocrine diseases (IRR 14.6, p < 0.001), dermatological diseases (IRR 3.7, p < 0.001), injuries and poisoning (IRR 2.7, p < 0.001), infectious diseases (IRR 2.5, p < 0.001), psychiatric diseases (IRR 2.0, p < 0.001), but also cardiovascular, hematological, genitourinary, neurologic and respiratory diseases compared with non-diabetic individuals. No difference was observed for hospital admissions due to cancer or musculoskeletal disorders. All-cause mortality was higher (HR 1.77, p < 0.001) in individuals with diabetes, with disease-specific mortality being significant only for cardiovascular and endocrine disease-related death.<br/><br/>Conclusions<br/>At the population level, prevalent diabetes increased the hospitalization burden longitudinally due to diseases of most of the ICD-10 main chapters, except for cancer and musculoskeletal disorders. These novel findings challenge the current view on the spectrum of prevalent diabetes-related conditions and may have implications for screening and treatment strategies in diabetes.}},
author = {{Johansson, Madeleine and Åkesson, Anna and Nilsson, Peter M. and Melander, Olle}},
issn = {{1471-2458}},
keywords = {{hospitalisation; diabetes mellitus}},
language = {{eng}},
month = {{10}},
pages = {{1--11}},
publisher = {{BioMed Central (BMC)}},
series = {{BMC Public Health}},
title = {{Longitudinal assessment of the impact of prevalent diabetes on hospital admissions and mortality in the general population: a prospective population-based study with 19 years of follow-up}},
url = {{http://dx.doi.org/10.1186/s12889-024-20435-7}},
doi = {{10.1186/s12889-024-20435-7}},
volume = {{24}},
year = {{2024}},
}