Background

Type 2 diabetes mellitus is associated with an increased risk of developing heart failure. However, few recent studies have examined the characteristics of older adults living in US nursing homes with heart failure and diabetes mellitus. This study is important for clinical practice and public health action plans for heart failure.

Objective

To estimate the prevalence of, and factors associated with, heart failure in long-stay nursing home residents with diabetes mellitus.

Methods

We conducted a cross-sectional study using the US 2016 Minimum Data Set data consisting of all residents with diabetes aged ≥65 years in Medicare/Medicaid certified nursing homes (n = 297,570). Diabetes mellitus and heart failure were operationalized using the resident's transfer notes at admission and the progress notes during admission through physical examination findings and current treatment orders.

Results

Among all residents with diabetes, 26.4% had heart failure. Increasing age of residents, and comorbidities including coronary artery disease (aOR: 1.34; 95% CI: 1.31–1.37), end stage renal disease (aOR: 1.30; 95% CI: 1.26–1.35), and chronic obstructive pulmonary disease (aOR: 1.60; 95% CI: 1.57–1.63) were associated with a higher odds of heart failure.

Conclusions

This is one of the first U.S studies to examine the prevalence and factors associated with heart failure in nursing home residents with diabetes mellitus. It highlights a clinically complex population with multiple comorbid conditions. Future research is needed to understand the pharmacological management of these residents and the extent to which appropriate management can improve quality of life for a medically vulnerable population.

中文翻译：

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美国疗养院糖尿病患者心力衰竭

 背景

2 型糖尿病与发生心力衰竭的风险增加有关。然而，最近很少有研究调查居住在美国疗养院的患有心力衰竭和糖尿病的老年人的特征。这项研究对于心力衰竭的临床实践和公共卫生行动计划非常重要。

 客观的

评估患有糖尿病的长期入住疗养院居民的心力衰竭患病率及其相关因素。

 方法

我们使用美国 2016 年最低数据集数据进行了一项横断面研究，数据包括 Medicare/Medicaid 认证疗养院中所有年龄≥65 岁的糖尿病居民（ n = 297,570）。通过体检结果和当前的治疗指令，使用住院医师入院时的转诊记录和入院期间的进展记录来操作糖尿病和心力衰竭。

 结果

在所有患有糖尿病的居民中，26.4%患有心力衰竭。居民年龄的增加以及合并症，包括冠状动脉疾病（aOR：1.34；95% CI：1.31–1.37）、终末期肾病（aOR：1.30；95% CI：1.26–1.35）和慢性阻塞性肺疾病（aOR：1.30；95% CI：1.26–1.35） ：1.60；95% CI：1.57-1.63）与心力衰竭的发生率较高相关。

 结论

这是美国首批调查糖尿病疗养院居民心力衰竭患病率和相关因素的研究之一。它强调了具有多种合并症的临床复杂人群。未来的研究需要了解这些居民的药物管理以及适当的管理可以在多大程度上改善医疗弱势群体的生活质量。