Comprehensive analysis of clinical characteristics, management, and prognosis in patients with dilated cardiomyopathy discharged from Spanish hospitals.

Objective: Dilated cardiomyopathy (DCM) is a leading cause of heart failure (HF) characterized by left ventricular dilatation and systolic dysfunction not explained by abnormal loading conditions. Despite its prevalence, DCM's epidemiology and prognosis remain poorly studied in our country.

Methods: A retrospective observational study encompassed patients discharged from all Spanish public hospitals between 2016 and 2021 diagnosed with DCM. Data were extracted from the Minimum Basic Data Set. The study focused on hospital admissions, comorbidities, in-hospital mortality, and readmission rates for circulatory system diseases at 30 and 365 days.

Results: Among 27,402 index episodes, DCM was the primary diagnosis in 12.4%, predominantly affecting men (72.5%). In-hospital mortality was 8.7%, with significant predictors including cardiogenic shock (OR: 12.4, 95% CI: 9.6-15.9), advanced or metastatic cancer (OR: 4.3, 95% CI: 3.8-5.0), renal failure (OR: 2.4, 95% CI: 2.2-2.7), and chronic liver disease (OR: 2.4, 95% CI: 2.1-2.8). Readmission rates were 7.9% at 30 days and 25.5% at 365 days, predominantly due to HF. Multivariate analysis identified age (IRR: 1.02, 95% CI: 1.01-1.02), female sex (IRR: 0.87, 95% CI: 0.79-0.96), severe hematological diseases (IRR: 2.12, 95% CI: 1.45-3.10), and metastatic cancer (IRR: 1.65, 95% CI: 1.31-2.07) as predictors of 30-day readmissions. At 365 days, predictors included age (IRR: 1.02, 95% CI: 1.01-1.02), female sex (IRR: 0.80, 95% CI: 0.74-0.86), severe hematological diseases (IRR: 2.43, 95% CI: 1.66-3.56), and renal failure (IRR: 1.42, 95% CI: 1.31-1.55).

Conclusion: This study highlights the substantial hospitalization burden and mortality risk among DCM patients, emphasizing the necessity for advanced management strategies and specialized cardiac care.