Diabetes Research Centre, University of Leicester, Leicester, England.
Nottingham University Hospitals and East Midlands Academic Health Science Network, Nottingham, England.
Diabetes Obes Metab. 2017 Oct;19(10):1371-1378. doi: 10.1111/dom.12941. Epub 2017 Apr 21.
To evaluate risk factors for hospital admissions for hypoglycaemia and compare length of hospitalization, inpatient mortality and hospital readmission between hypoglycaemia- and non-hypoglycaemia-related admissions.
We used all admissions for hypoglycaemia in individuals with diabetes to English NHS hospital trusts between 2005 and 2014 (101 475 case admissions) and 3 random admissions per case in individuals with diabetes without hypoglycaemia (304 425 control admissions). Risk factors and differences in the 3 outcomes were estimated with logistic and negative binomial regressions.
A U-shaped relationship between age and risk of admission for hypoglycaemia was observed until the age of 85 years; compared to the nadir at 60 years, the risk was progressively higher in younger and older patients and steadily declined after 85 years. Social deprivation (positively) and comorbidities (negatively) were associated with the risk of admission for hypoglycaemia. Compared to Caucasians, other ethnic groups had lower (Bangladeshi, Pakistani, Indians) or higher (Caribbean) risk of admission for hypoglycaemia. Length of hospitalization was 26% shorter while risk of rehospitalization was 65% higher in individuals admitted for hypoglycaemia. Compared to admissions for hypoglycaemia, risk of inpatient mortality was 50% lower for unstable angina but higher for acute myocardial infarction (3 times), acute renal failure (5 times) or pneumonia (8 times).
Among hospital-admitted individuals with diabetes, age, social deprivation, comorbidities and ethnicity are associated with higher frequency of hospitalization for hypoglycaemia. Admission for hypoglycaemia is associated with a greater risk of readmission, a shorter length of hospitalisation and a generally lower inpatient mortality compared to admissions for other medical conditions. These results could help in identifying at-risk groups to reduce the burden of hospitalization for hypoglycaemia.
评估因低血糖住院的危险因素，并比较低血糖相关和非低血糖相关住院的住院时间、住院死亡率和再次住院率。
我们使用了 2005 年至 2014 年期间所有患有糖尿病的个体因低血糖住院的英国国民保健制度医院信托数据（101475 例病例住院）和每例患有糖尿病但无低血糖的个体随机住院 3 次的数据（304425 例对照住院）。使用逻辑回归和负二项回归估计了危险因素和这三个结果之间的差异。
观察到年龄与低血糖住院风险之间存在 U 型关系，直到 85 岁；与 60 岁时的最低点相比，年轻和老年患者的风险逐渐增加，85 岁后则稳步下降。社会贫困（正相关）和合并症（负相关）与低血糖住院风险相关。与白种人相比，其他族裔群体（孟加拉人、巴基斯坦人、印度人）低血糖住院风险较低，或更高（加勒比人）。低血糖住院患者的住院时间缩短 26%，再次住院风险增加 65%。与低血糖住院相比，不稳定型心绞痛住院的住院死亡率降低 50%，而急性心肌梗死（3 倍）、急性肾衰竭（5 倍）或肺炎（8 倍）的住院死亡率则升高。
在住院的糖尿病患者中，年龄、社会贫困、合并症和种族与因低血糖住院的频率增加有关。与因其他医疗状况住院相比，低血糖住院与再住院风险增加、住院时间缩短和总体住院死亡率降低有关。这些结果有助于识别高危人群，以降低低血糖住院的负担。
