Valent Francesca, Tonutti Laura, Grimaldi Franco
SOC Istituto di Igiene ed Epidemiologia Clinica, Azienda Sanitaria Universitaria Integrata di Udine, Via Colugna 50, 33100, Udine, Italy.
Endocrinology, Diabetes, Metabolism and Clinical Nutrition, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy.
Acta Diabetol. 2017 Dec;54(12):1081-1090. doi: 10.1007/s00592-017-1050-6. Epub 2017 Sep 15.
Hospitalized patients with comorbid diabetes mellitus may have worse outcomes than the others. We conducted a study to assess whether comorbid diabetes affects in-hospital mortality and length of stay.
For this population-based study, we analyzed the administrative databases of the Regional Health Information System of the Region Friuli Venezia Giulia, where the Hospital of Udine is located. Hospital discharge data were linked at the individual patient level with the regional Diabetes Mellitus Registry to identify diabetic patients. For each 3-digit ICD-9-CM discharge diagnosis code, we assessed the difference in length of stay and in-hospital mortality between diabetic and non-diabetic patients. We conducted both univariate and multivariate analyses, adjusted for age, sex, Charlson's comorbidity score, and urgency of hospitalization, through linear and logistic regression models.
After adjusting for potential confounders, diabetes significantly increased the risk of in-hospital death among patients hospitalized for bacterial pneumonia (OR = 1.94) and intestinal obstruction (OR = 4.23) and length of stay among those admitted for several diagnoses, including acute myocardial infarction and acute renal failure. Admission glucose blood level was associated with in-hospital death in patients with pneumonia and intestinal obstruction, and increased length of stay for several conditions.
Patients with diabetes mellitus who are hospitalized for other health problems may have increased risk of in-hospital death and longer hospital stay. For this reason, diabetes should be promptly recognized upon admission and properly managed.
合并糖尿病的住院患者可能比其他患者预后更差。我们开展了一项研究，以评估合并糖尿病是否会影响住院死亡率和住院时间。
在这项基于人群的研究中，我们分析了位于乌迪内的医院所在的弗留利-威尼斯朱利亚大区区域卫生信息系统的管理数据库。医院出院数据在个体患者层面与区域糖尿病登记处相链接，以识别糖尿病患者。对于每一个3位数字的ICD-9-CM出院诊断代码，我们评估了糖尿病患者与非糖尿病患者在住院时间和住院死亡率方面的差异。我们通过线性和逻辑回归模型进行了单变量和多变量分析，并对年龄、性别、查尔森合并症评分和住院紧急程度进行了调整。
在对潜在混杂因素进行调整后，糖尿病显著增加了因细菌性肺炎住院患者的院内死亡风险（OR = 1.94）和肠梗阻患者的院内死亡风险（OR = 4.23），并增加了包括急性心肌梗死和急性肾衰竭在内的几种诊断患者的住院时间。入院血糖水平与肺炎和肠梗阻患者的院内死亡相关，并在多种情况下增加住院时间。
因其他健康问题住院的糖尿病患者可能有更高的院内死亡风险和更长的住院时间。因此，糖尿病在入院时应被及时识别并得到妥善管理。
