Sex-Related Disparities in the Incidence and Outcomes of Ischemic Stroke among Type 2 Diabetes Patients. A Matched-Pair Analysis Using the Spanish National Hospital Discharge Database for Years 2016–2018

Background: To analyze the incidence, use of therapeutic procedures, and in-hospital outcomes among patients suffering an ischemic stroke (IS) according to the presence of type 2 diabetes mellitus (T2DM) in Spain (2016–2018) and to assess the existence of sex differences. Methods: Matched-pair analysis using the Spanish National Hospital discharge. Results: IS was coded in 92,524 men and 79,731 women (29.53% with T2DM). The adjusted incidence of IS (IRR 2.02; 95% CI 1.99–2.04) was higher in T2DM than non-T2DM subjects, with higher IRRs in both sexes. Men with T2DM had a higher incidence of IS than T2DM women (IRR 1.54; 95% CI 1.51–1.57). After matching patients with T2DM, those with other comorbid conditions, however, significantly less frequently received endovascular thrombectomy and thrombolytic therapy. In-hospital mortality (IHM) was lower among T2DM men than matched non-T2DM men (8.23% vs. 8.71%; p < 0.001). Women with T2DM had a higher IHM rate than T2DM men (11.5% vs. 10.20%; p = 0.004). After adjusting for confounders, women with T2DM had a 12% higher mortality risk than T2DM men (OR 1.12; 95% CI 1.04–1.21). Conclusions: T2DM is associated with higher incidence of IS in both sexes. Men with T2DM have a higher incidence rates of IS than T2DM women. Women with T2DM have a higher risk of dying in the hospital.

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Impact of Type 2 Diabetes on Oncologic Outcomes of Hepatocellular Carcinomas in Non-Cirrhotic, Non-alcoholic Steatohepatitis: a Matched-Pair Analysis

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-020-04628-0 ◽

2020 ◽

Cited By ~ 1

Author(s):

Adrian T. Billeter ◽

Philip C. Müller ◽

Thomas Albrecht ◽

Stephanie Roessler ◽

Moritz Löffler ◽

...

Keyword(s):

Type 2 Diabetes ◽

Oncologic Outcomes ◽

Matched Pair ◽

Alcoholic Steatohepatitis ◽

Matched Pair Analysis ◽

Hepatocellular Carcinomas ◽

Pair Analysis

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The influence of sex on ischemic stroke incidence, therapeutic procedures and in‐hospital mortality: Results of the Spanish National Hospital Discharge

International Journal of Clinical Practice ◽

10.1111/ijcp.14984 ◽

2021 ◽

Author(s):

José M. Miguel‐Yanes ◽

Rodrigo Jiménez‐García ◽

Ana López‐de‐Andrés ◽

Valentín Hernández‐Barrera ◽

Javier Miguel‐Díez ◽

...

Keyword(s):

Ischemic Stroke ◽

Hospital Mortality ◽

Hospital Discharge ◽

National Hospital ◽

Stroke Incidence ◽

Therapeutic Procedures

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Association of type 2 diabetes with in-hospital complications among women undergoing breast cancer surgical procedures. A retrospective study using the Spanish National Hospital Discharge Database, 2013–2014

BMJ Open ◽

10.1136/bmjopen-2017-017676 ◽

2017 ◽

Vol 7 (11) ◽

pp. e017676 ◽

Cited By ~ 2

Author(s):

Ana Lopez-de-Andres ◽

Isabel Jimenez-Trujillo ◽

Valentin Hernandez-Barrera ◽

Javier de Miguel-Diez ◽

Manuel Mendez-Bailon ◽

...

Keyword(s):

Breast Cancer ◽

Type 2 Diabetes ◽

Retrospective Study ◽

Hospital Discharge ◽

Surgical Procedures ◽

Surgical Procedure ◽

National Hospital ◽

Hospital Discharge Database ◽

Discharge Database

ObjectivesTo compare the type of surgical procedures used, comorbidities, in-hospital complications (IHC) and in-hospital outcomes between women with type 2 diabetes mellitus (T2DM) and age-matched women without diabetes who were hospitalised with breast cancer. In addition, we sought to identify factors associated with IHC in women with T2DM who had undergone surgical procedures for breast cancer.DesignRetrospective study using the National Hospital Discharge Database, 2013–2014.SettingSpain.ParticipantsWomen who were aged ≥40 years with a primary diagnosis of breast cancer and who had undergone a surgical procedure. We grouped admissions by T2DM status. We selected one matched control for each T2DM case.Main outcome measuresThe type of procedure (breast-conserving surgery (BCS) or mastectomy), clinical characteristics, complications, length of hospital stay and in-hospital mortality.ResultsWe identified 41 458 admissions (9.23% with T2DM). Overall, and in addition to the surgical procedure, we found that comorbidity, hypertension and obesity were more common among patients with T2DM. We also detected a higher incidence of mastectomy in women with T2DM (44.69% vs 42.42%) and a greater rate of BCS in patients without T2DM (57.58% vs 55.31%). Overall, non-infectious complications were more common among women with T2DM (6.40% vs 4.56%). Among women who had undergone BCS or a mastectomy, IHC were more frequent among diabetics (5.57% vs 3.04% and 10.60% vs 8.24%, respectively). Comorbidity was significantly associated with a higher risk of IHC in women with diabetes, independent of the specific procedure used.provinceConclusionsWomen with T2DM who undergo surgical breast cancer procedures have more comorbidity, risk factors and advanced cancer presentations than matched patients without T2DM. Mastectomies are more common in women with T2DM. Moreover, the procedures among women with T2DM were associated with greater IHC. Comorbidity was a strong predictor of IHC in women with T2DM.

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Sex Differences in the Incidence and Outcomes of Acute Myocardial Infarction in Spain, 2016–2018: A Matched-Pair Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10081795 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1795

Author(s):

José M. de Miguel-Yanes ◽

Rodrigo Jiménez-García ◽

Valentin Hernandez-Barrera ◽

Javier de Miguel-Díez ◽

Nuria Muñoz-Rivas ◽

...

Keyword(s):

Myocardial Infarction ◽

Coronary Intervention ◽

Incidence Rates ◽

St Elevation Myocardial Infarction ◽

Matched Pair ◽

Matched Pair Analysis ◽

Percutaneous Coronary ◽

St Elevation ◽

Pair Analysis ◽

Discharge Database

(1) Background: Our aim was to analyze the incidence, procedures, and in-hospital outcomes of myocardial infarction (MI) in Spain (2016–2018) according to sex. (2) Methods: We estimated the incidence of an ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI) according to sex using the Spanish National Hospital Discharge Database. A matched-pair analysis was used. (3) Results: MI was coded in 156,826 patients aged ≥18 years (111,842 men and 44,984 women). Men showed higher incidence rates (205.0 vs. 77.8 per 100,000; p < 0.001; IRR = 2.81(95%CI:2.78–2.84)). After matching, the use of coronary artery by-pass grafting (CABG) (1.0% vs. 0.7%; p < 0.001) and percutaneous coronary intervention (PCI) (57.8% vs. 52.3%; p < 0.001) was higher among men with an STEMI, whereas the in-hospital mortality (IHM) remained higher among women (11.2% vs. 10.1%; p < 0.001). Likewise, CABG (1.9% vs. 3.3%; p < 0.001) and PCI (33.8% vs. 41.9%; p < 0.001) were less often used among women with an NSTEMI, but no sex-related differences were found in IHM. After adjusting for confounders, IHM was more than twofold higher for both men and women with an STEMI than those with an NSTEMI. Women with an STEMI had a 21% higher mortality risk than men (OR = 1.21(95%CI:1.13–1.29). (4) Conclusion: Men had higher incidence rates of MI than women. Women underwent invasive procedures less often and had a higher IHM when admitted for an STEMI.

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P6385Association of prehospital acetylsalicylic acid and heparin administration with favourable neurological outcome after out-of-hospital cardiac arrest: a matched-pair analysis

European Heart Journal ◽

10.1093/eurheartj/ehz746.0981 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

U Grabmaier ◽

M Von Der Helm ◽

S Massberg ◽

L T Weckbach ◽

M Fischer

Keyword(s):

Cardiac Arrest ◽

Acetylsalicylic Acid ◽

Hospital Discharge ◽

Neurological Outcome ◽

Matched Pair ◽

Matched Pair Analysis ◽

Secondary Endpoints ◽

Pair Analysis ◽

Hospital Cardiac Arrest ◽

Resuscitation Registry

Abstract Background/Introduction To date, no prehospital administered drug has shown to influence favourable neurological outcome in patients with out-of-hospital cardiac arrest (OHCA). Early administration of antiplatelet and anticoagulant medication might affect organ microcirculation and therefore favourable neurological outcome in the setting of OHCA. Purpose To evaluate the effect of prehospital acetylsalicylic acid and heparin (AH) administration on favourable neurological outcome and overall survival after OHCA in a large multicentre registry. Methods We examined patients with cardiac causes of OHCA that were prospectively included in the German Resuscitation Registry. Patients that were administered AH in the prehospital setting were matched in a 1:4 ratio with patients that were not administered AH. Pairs were matched for age >80 years, public place of collapse, initial ECG rhythm, witnessed by lay people and by emergency medical services (EMS), bystander CPR, usage of vasopressors, ECG signs of ACS or diagnosed ACS, coronary angiography conducted and hypothermia conducted. Analyses in the patients were stratified by treatment arm. Data was collected from 2011 to 2017 and analysed from January 2019 to March 2019. The primary endpoint was favourable neurological outcome at hospital discharge defined as cerebral performance category (CPC) 1 or 2. Secondary endpoints were return of spontaneous circulation (ROSC) as well as survival to hospital discharge. Logistic regression analysis and chi square analysis were used to evaluate the primary and secondary endpoints, respectively. Results Within the German Resuscitation Registry, 17,139 patients included between 2011 and 2017 had a presumably cardiac cause of OHCA with completed follow-up data. 205 patients were administered AH in the prehospital setting, whereas 16,934 were not. After matching in a 1:4 ratio, 174 patients in the AH group and 696 in the noAH group were suitable for analysis of the primary and the secondary endpoints. Prehospital AH administration was associated with favourable neurological outcome (OR for CPC 1 or 2 at hospital discharge 1.489 [1.026–2.162], p=0.036). Patients with AH were more likely to have ROSC (73.6% vs. 65.7% in the noAH group, p=0.047). Survival to hospital discharge was not statistically different between groups (32.8% vs. 28.5% in the noAH group). Consort flow-diagram Conclusion(s) In this matched-pair analysis, prehospital administration of AH was associated with an enhanced ROSC rate and with favorable neurological outcome. Randomized controlled trials are needed to confirm these results.

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