Long-term Mortality Risk After Hyperglycemic Crisis Episodes in Geriatric Patients With Diabetes: A National Population-Based Cohort Study

doi:10.2337/dc14-1840

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標題:	Long-term Mortality Risk After Hyperglycemic Crisis Episodes in Geriatric Patients With Diabetes: A National Population-Based Cohort Study
作者:	Huang, Chien-Cheng Weng, Shih-Feng Tsai, Kang-Ting Chen, Ping-Jen Lin, Hung-Jung Wang, Jhi-Joung Su, Shih-Bin Chou, Willy Guo, How-Ran Hsu, Chien-Chin
貢獻者:	休閒保健管理系
關鍵字:	Ischemic-Stroke Diagnosis Mellitus Database History TAIWAN Score
日期:	2015-05
上傳時間:	2016-04-19 19:02:27 (UTC+8)
出版者:	Amer Diabetes Assoc
摘要:	OBJECTIVEHyperglycemic crisis is one of the most serious diabetes-related complications. The increase in the prevalence of diabetes in the geriatric population leads to a large disease burden, but previous studies of geriatric hyperglycemic crisis were focused on acute hyperglycemic crisis episode (HCE). This study aimed to delineate the long-term mortality risk after HCE.RESEARCH DESIGN AND METHODSThis retrospective national population-based cohort study reviewed, in Taiwan's National Health Insurance Research Database, data from 13,551 geriatric patients with new-onset diabetes between 2000 and 2002, including 4,517 with HCE (case subjects) (ICD-9 code 250.1 or 250.2) and 9,034 without HCE (control subjects). The groups were compared and followed until 2011.RESULTSOne thousand six hundred thirty-four (36.17%) case and 1,692 (18.73%) control subjects died (P < 0.0001) during follow-up. Incidence rate ratios (IRRs) of death were 2.82 times higher in case subjects (P < 0.0001). The mortality risk was highest in the first month (IRR 26.56; 95% CI 17.97-39.27) and remained higher until 4-6 years after the HCE (IRR 1.49; 95% CI 1.23-1.81). After adjustment for age, sex, selected comorbidities, and monthly income, the mortality hazard ratio was still 2.848 and 4.525 times higher in case subjects with one episode and two or more episodes of hyperglycemic crisis, respectively. Older age, male sex, renal disease, stroke, cancer, chronic obstructive pulmonary disease, and congestive heart failure were independent mortality predictors.CONCLUSIONSPatients with diabetes had a higher mortality risk after HCE during the first 6 years of follow-up. Referral for proper education, better access to medical care, effective communication with a health care provider, and control of comorbidities should be done immediately after HCE.
關聯:	Diabetes Care, v.38 n.5, pp.746-751
显示于类别:	[休閒保健管理系(所)] 期刊論文

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