Int J Clin Pract. 2018;e13283. wileyonlinelibrary.com/journal/ijcp
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1 of 11
https://doi.org/10.1111/ijcp.13283
© 2018 John Wiley & Sons Ltd
Received: 14 August 2018
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Revised: 2 October 2018
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Accepted: 9 October 2018
DOI: 10.1111/ijcp.13283
ORIGINAL PAPER
In-hospital outcomes for solid organ transplants according
to type 2 diabetes status: An observational, 15-year study in
Spain
José M. de Miguel-Yanes
1
| Rodrigo Jiménez-García
2
|
Javier de Miguel-Díez
3
| Valentín Hernández-Barrera
2
| Manuel Méndez-Bailón
4
|
Nuria Muñoz-Rivas
5
| Ana López-de-Andrés
2
1
Internal Medicine Department, Hospital
General Universitario Gregorio
Marañón, Universidad Complutense de
Madrid, Madrid, Spain
2
Preventive Medicine and Public Health
Teaching and Research Unit, Health
Sciences Faculty, Rey Juan Carlos University,
Alcorcón, Madrid, Spain
3
Respiratory Care Department, Hospital
General Universitario Gregorio
Marañón, Universidad Complutense de
Madrid, Instituto de Investigación Sanitaria
Gregorio Marañón (IiSGM), Madrid, Spain
4
Internal Medicine Department, Hospital
Universitario Clínico San Carlos, Universidad
Complutense de Madrid, Madrid, Spain
5
Internal Medicine Department, Hospital
Universitario Infanta Leonor, Madrid, Spain
Correspondence
Rodrigo Jiménez-García, Preventive
Medicine and Public Health Teaching and
Research Unit, Health Sciences Faculty, Rey
Juan Carlos University, Alcorcón, Madrid,
Spain.
Email: rodrigo.jimenez@urjc.es
Funding information
This study forms part of research funded
by the FIS (Fondo de Investigaciones
Sanitarias—Health Research Fund, grant no.
PI16/00564, Instituto de Salud Carlos III),
cofinanced by the European Union through
the Fondo Europeo de Desarrollo Regional
(FEDER, “Una manera de hacer Europa”). The
funding sources had no involvement at any
step of the research done or in the process
of writing this manuscript.
Summary
Aims: To describe trends and outcomes during admission for solid organ transplant in
people with or without type 2 diabetes in Spain, 2001-2015.
Methods: We used national hospital discharge data to select all hospital admissions
for kidney, lung, heart, and liver transplant. We estimated admission rates stratified
by type 2 diabetes status. We built Poisson regression models to compare the ad-
justed time trends in admission rates. We tested in-hospital mortality (IHM) in logistic
regression analyses.
Results: We identified 50 964 transplants (16.7% in people with type 2 diabetes):
kidney, 30 919; lung, 2810; heart, 3649; liver, 13 586. The overall adjusted incidence
rate ratios (95% confidence intervals) of admission in people with type 2 diabetes vs
no diabetes were 2.4 (2.32-2.48) for kidney, 1.51 (1.33-1.70) for lung, 2.87 (2.63-3.13)
for heart, and 4.16 (3.99-4.33) for liver transplant. In the multivariate analysis, IHM
decreased significantly over time for all types of transplant. Type 2 diabetes indepen-
dently predicted lower IHM during admission only for heart (Odds ratio, OR [95%
CI] = 0.62 [0.47-0.81]) and liver transplant (OR [95% CI] = 0.69 [0.58-0.82]).
Conclusions: Admission rates for solid organ transplant were higher in people with
type 2 diabetes than in people without diabetes. Type 2 diabetes was associated with
lower in-hospital mortality during admission for heart and liver transplant.