Lai Shih-Wei, Lin Cheng-Li, Liao Kuan-Fu
College of Medicine Department of Family Medicine Management Office for Health Data, China Medical University Hospital, Taichung College of Medicine, Tzu Chi University, Hualien Department of Internal Medicine, Taichung Tzu Chi General Hospital Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.
Medicine (Baltimore). 2017 Sep;96(36):e7763. doi: 10.1097/MD.0000000000007763.
We assessed the association between diabetes mellitus and the risk of pleural empyema in Taiwan.A population-based retrospective cohort study was conducted using the database of the Taiwan National Health Insurance Program. There were 28,802 subjects aged 20 to 84 years who were newly diagnosed with diabetes mellitus from 2000 to 2010 as the diabetes group and 114,916 randomly selected subjects without diabetes mellitus as the non-diabetes group. The diabetes group and the non-diabetes group were matched by sex, age, comorbidities, and the year of index date. The incidence of pleural empyema at the end of 2011 was estimated. A multivariable Cox proportional hazards regression model was used to estimate the hazard ratio (HR) and 95% confidence interval (95% CI) for pleural empyema associated with diabetes mellitus.The overall incidence of pleural empyema was 1.65-fold higher in the diabetes group than that in the non-diabetes group (1.58 vs 0.96 per 10,000 person-years, 95% CI 1.57-1.72). After adjusting for confounders, a multivariable Cox proportional hazards regression model revealed that the adjusted HR of pleural empyema was 1.71 in subjects with diabetes mellitus (95% CI 1.16-2.51), compared with those without diabetes mellitus. In further analysis, even in the absence of any comorbidity, the adjusted HR was 1.99 for subjects with diabetes mellitus alone (95% CI 1.18-3.38).Diabetic patients confer a 1.71-fold increased hazard of developing pleural empyema. Even in the absence of any comorbidity, the risk remains existent.
我们评估了台湾地区糖尿病与胸膜腔积脓风险之间的关联。我们利用台湾全民健康保险计划的数据库进行了一项基于人群的回顾性队列研究。将2000年至2010年新诊断为糖尿病的28802名20至84岁受试者作为糖尿病组，随机选取114916名无糖尿病受试者作为非糖尿病组。糖尿病组和非糖尿病组按性别、年龄、合并症及索引日期年份进行匹配。估算了2011年末胸膜腔积脓的发病率。采用多变量Cox比例风险回归模型估算与糖尿病相关的胸膜腔积脓的风险比（HR）及95%置信区间（95%CI）。糖尿病组胸膜腔积脓的总体发病率比非糖尿病组高1.65倍（每10000人年分别为1.58例和0.96例，95%CI 1.57 - 1.72）。在对混杂因素进行调整后，多变量Cox比例风险回归模型显示，糖尿病患者胸膜腔积脓的调整后HR为1.71（95%CI 1.16 - 2.51），与非糖尿病患者相比。在进一步分析中，即使没有任何合并症，仅糖尿病患者的调整后HR为1.99（95%CI 1.18 - 3.38）。糖尿病患者发生胸膜腔积脓的风险增加1.71倍。即使没有任何合并症，风险依然存在。
