The influence of diabetes on in-hospital complications and mortality in a Cardiovascular Intensive Care Unit in sub Saharan Africa
Martin Hongieh Abanda1,2,&, Anastase Dzudie1,3,4,5, Simeon
Pierre Choukem3,6, Felicite Kamdem3,4,7, Yacouba Mapoure3,4,7,
Romuald Hentchoya4, Henry Luma3,6
1Non-communicable Disease Research Unit, Clinical Research Education, Networking & Consultancy (CRENC), Douala, Cameroon, 2District Hospital Bafang, Bafang, Cameroon, 3Department of Internal Medicine, Douala General Hospital, Douala, Cameroon, 4Cardiovascular Intensive Care Unit, Douala General Hospital, Douala, Cameroon, 5Faculty of Biomedical and Pharmaceutical Sciences, University of Yaounde I, Yaounde, Cameroon, 6Faculty of Health Sciences, University of Buea, Buea, Cameroon, 7Faculté des Sciences Biomédicale et Pharmaceutiques, Université de Douala, Douala, Cameroun
Martin Hongieh Abanda, Non-communicable Disease Research Unit, Clinical Research Education, Networking & Consultancy (CRENC), Douala, District Hospital Bafang, Bafang, Cameroon
patients living with type 2 diabetes are at increased risk of cardiovascular related death but there is little data on the influence of diabetes on early outcomes of cardiovascular emergencies (CVEs). This study aimed at describing the influence of diabetes on early outcome of patients admitted for CVEs.
database of Cardiovascular Intensive Care Unit (CICU) of the Douala General Hospital was queried for patients admitted for CVEs between November 2012 and November 2015. We compared patients with and without known diabetes for sociodemographic profile and risk factors for CVEs using 2-sided tests (Chi-squared & one-way ANOVA). While Cox regression and Kaplan Meier survival models were used to compare in-hospital complications and mortality.
of the 333 patients admitted during the study period, 99 (29.7%) had a diagnosis
of diabetes. Patients with diabetes were older (65.8 ± 13.8 vs 60.4 ± years,
p < 0.001)
with a similar sex distribution to patients without diabetes. Hypertension
(90.9% vs 68.4%, p < 0.001), dyslipidemia (44.4% vs 6.4%, p < 0.001), sedentary
lifestyle (68.7% vs 44.8%, p = 0.001) and gout (15.2% vs 6.8%, p = 0.02)
were more frequent
in patients with diabetes. Stroke (54.3% vs 37.2%), acute heart failure (26.3%
vs 24.8%), acute coronary syndrome (6.1% vs 2.1%) and complications [(p < 0.001):
infectious (41.4% vs 23.5%), cardiovascular (16.2% vs 12.8%) and multi-systemic
failure (9.1% vs 1.7%)] were also more frequent in patients with diabetes.
Complications occurred much earlier (p<0.001), estimated survival time was shorter
(p < 0.001)
and mortality was higher in patients with diabetes [46.5% vs 25.6%, adjusted
Hazard Ratio (aHR) for age & sex was 1.77 (95% CI: 1.18 – 2.64), adj-p = 0.005].
about 1 in every 3 patients admitted for CVEs in our unit has diabetes. Death is about two times more likely in patients with diabetes. Thorough assessment and rigorous monitoring are warranted to prevent the excess complications and mortality in patients with diabetes at the CICU.