Predictor of Mortality after Hospital Discharge in the Elderly with Type 2 Diabetes Mellitus—Follow-Up of Two Years

Abstract

Muscle-related loss of the aging process can worsen the individual’s functionality as well as reduce gait and strength of the handgrip. The Gait speed test reflects the health and functional status of the elderly as well as being a predictor of survival. In older adults with diabetes there seems to be a strong correlation between gait and worse outcomes. Objective: To determine the relationship between gait speed test and all-cause mortality after discharge in the elderly with type 2 diabetes melito (T2DM). Methodology: A prospective study that included hospitalized patients at the Hospital de Clínicas of Porto Alegre (HCPA, South of Brazil) from July 2015 to December 2016, with T2DM, aged over 60 years and up to 48 hours of hospitalization in one unit. Follow-up was done by telephone and by consulting the medical records. In order to evaluate the walk, a 6-meter walking test, such as Time Up and Go (TUG), was performed, muscle strength was measured using an dynamometer and muscle mass was measured in the largest region of the circumference of the calf (CC). The patients were considered with reduced gait when they completed the test in the value below 0.8 m/s. This project was approved by the HCPA Ethics Committee under Number150068. Results: 312 patients with T2DM were included, mean age 71.31 ± 6.45 of which 51% were women, 82% were Caucasian. The mean velocity in the TUG was 0.54 m/s (0.46-0.66) and presented a positive correlation with age (r = 0.283, p <0.001), duration of hospitalization (r = 0.081, p = 0.17) and negative correlation with BMI (r = -0.42, p = 0.48). The mortality was 45.3%. In the multivariate analysis after adjustment for age, sex, physical activity, and BMI the lower gait speed test and the CC maintained an association with post-high mortality (OR = 2.064, 95% CI 1.048-4.063 p = 0.036 and OR = 0.872, 95% CI 0.78-0.96 p = 0.010). Conclusion: patients with DM2 who had reduced speed gait and CP, had a greater risk of death after hospital discharge. Disclosure M.V. Beretta: None. J.V. Feldman: None. T. Rodrigues: None.