糖尿病死亡率的预后指标。

Prognostic indices of diabetes mortality.

作者信息

Ogbera Anthonia Okeoghene, Chinenye Sunny, Onyekwere Asabamaka, Fasanmade Olufemi

机构信息

Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria.

出版信息

Ethn Dis. 2007 Autumn;17(4):721-5.

PMID:18072385

Abstract

INTRODUCTION

Diabetes mellitus is an important cause of morbidity and mortality worldwide and the burden associated with it is felt more in developing countries. Communicable diseases, as opposed to non-communicable diseases, remain a top priority in developing countries like Nigeria. This report sets out to highlight the current status of diabetes-related hospitalizations in Nigeria and also to make comparisons with past reports. This goal will be achieved primarily by determining the prognostic factors associated with diabetes mortality and also noting the duration of hospital stay for the major causes of diabetes deaths.

METHOD

From January through December 2006, subjects with diabetes mellitus (DM) in a tertiary hospital in Nigeria were prospectively studied after admission to assess their shortterm outcome which was defined as death. The total mortality, causes of death, associated complications and duration of hospital stay were noted. The predictive factors for DM morbidity were evaluated using chi test, logistic regression. Students t test was computed for quantitative data.

RESULTS

A total of 1,327 subjects were admitted to the Medical wards for the duration of the study and the crude death rate was 11%. DM related admissions made up 206 (15%) of all the medical admissions and the case fatality rate was 33 (16%). The most common reasons for DM admission were hyperglycaemic emergencies (HE), 88 (40%) and hypertension, 44 (21%). The most common causes of deaths were HE, 15 (46%) and DM foot ulcers (DFU), 10 (30%) while DFU and cerebrovascular accident (CVA) had the highest case fatality rates of 28% and 25% respectively. DFU had the most prolonged duration of admission ranging from 15-122 days. DFU, CVD and having type 2 DM were highly predictive of fatal outcomes. The odds ratio and 95% CI for these factors were 4.5 (1.5-12.7), 3.0 (0.9-9.92 and 3.1 (0.7-14) respectively.

CONCLUSION

DFU and HE are potentially remediable causes of mortality in DM. DFU as seen by the prolonged hospital stay imposes a huge burden on health resources. Better and early intervention of DFU is necessary to reduce the resultant disease burden.

摘要

引言

糖尿病是全球发病和死亡的重要原因，发展中国家所承受的相关负担更为沉重。与非传染性疾病不同，传染病在尼日利亚等发展中国家仍然是首要重点。本报告旨在突出尼日利亚糖尿病相关住院情况的现状，并与以往报告进行比较。这一目标将主要通过确定与糖尿病死亡率相关的预后因素以及记录糖尿病死亡主要原因的住院时长来实现。

方法

2006年1月至12月，对尼日利亚一家三级医院收治的糖尿病患者进行前瞻性研究，评估其短期转归，即死亡情况。记录总死亡率、死亡原因、相关并发症及住院时长。采用卡方检验、逻辑回归评估糖尿病发病的预测因素。对定量数据进行学生t检验。

结果

在研究期间，共有1327名患者入住内科病房，粗死亡率为11%。糖尿病相关住院患者占所有内科住院患者的206例（15%），病死率为33例（16%）。糖尿病住院最常见的原因是高血糖急症（HE），88例（40%），其次是高血压，44例（21%）。最常见的死亡原因是高血糖急症，15例（46%），糖尿病足溃疡（DFU），10例（30%），而糖尿病足溃疡和脑血管意外（CVA）的病死率最高，分别为28%和25%。糖尿病足溃疡的住院时间最长，为15 - 122天。糖尿病足溃疡、心血管疾病和2型糖尿病是死亡结局的高度预测因素。这些因素的比值比和95%置信区间分别为4.5（1.5 - 12.7）、3.0（0.9 - 9.92）和3.1（0.7 - 14）。