Prudius D, Weber P, Matějovská Kubešová H, Meluzínová H, Polcarová V, Bieláková K
Department of Internal Medicine,Geriatrics and Practical Medicine, Faculty Hospital Brno and Masaryk University, Jihlavska 20, Brno, 625 00, Czech Republic;
Adv Gerontol. 2017;30(5):703-708.
The aim was to compare an occurrence of acute PE in hospitalized patients 65+ years old with diabetes mellitus (DM) with those without any DM. It was a retrospective analysis of data collected in documentation of patients who were hospitalized at the geriatric department in the years 2007-2015. In this period we had 11 947 patients of an average age of 79,9±8,5 years (min - 65, max - 103 years). Out of this number there were 4 069 diabetics. Acute PE was found in 344 patients of an average age 80,3±7,4 years. 121 of them died (35,3%) and 223 survived (64,7%). From total patients 88 were diabetics with PE. Mortality on PE did not influence the presence of DM. She was the same in both groups of patients (p=NS) - with and without DM.
Prevalence PE in the hospitalized 65+ years old was 2,9%. Mortality of PE among all the hospitalized 65+ was 1,0%. Higher prevalence of PE was found in non-diabetics - 3,2%, as compared to the diabetics - 2,3% (p<0,025). The average age of patients with diabetes both with and without PE was lower as compared to the non-diabetics (p<0,01). Among risk factors we found significantly more frequently obesity in the diabetics as compared to the non-diabetics both surviving (p<0,001) and those who died (p<0,05). The most important risk factor of PE was in all the patient's immobility. One risk factor appeared in the set of survivors more frequently in the non-diabetics as compared to the diabetics (p<0,05). Simultaneous occurrence of three risk factors appeared more frequently in the surviving diabetics (p<0,001) as compared to the non-diabetics. Although overall presence of risk factors was higher in the diabetics, PE prevalence in the DM patients was lower as compared to the non-diabetics. The immobility in general was the most important risk factor for PE occurrence, in the diabetics then also obesity.
目的是比较65岁及以上患有糖尿病(DM)的住院患者与无糖尿病患者中急性肺栓塞(PE)的发生率。这是一项对2007年至2015年在老年科住院患者病历中收集的数据进行的回顾性分析。在此期间,我们有11947名患者,平均年龄为79.9±8.5岁(最小65岁,最大103岁)。其中有4069名糖尿病患者。在344名平均年龄为80.3±7.4岁的患者中发现了急性肺栓塞。其中121人死亡(35.3%),223人存活(64.7%)。在所有患者中,88名是患有肺栓塞的糖尿病患者。肺栓塞导致的死亡率不受糖尿病的影响。在有糖尿病和无糖尿病的两组患者中(p=无显著差异)死亡率相同。
65岁及以上住院患者中肺栓塞的患病率为2.9%。所有65岁及以上住院患者中肺栓塞的死亡率为1.0%。与糖尿病患者的2.3%相比,非糖尿病患者中肺栓塞的患病率更高,为3.2%(p<0.025)。与非糖尿病患者相比,患有和未患有肺栓塞的糖尿病患者的平均年龄更低(p<0.01)。在危险因素中,我们发现无论是存活的(p<0.001)还是死亡的(p<0.05)糖尿病患者中肥胖的发生率都显著高于非糖尿病患者。肺栓塞最重要的危险因素在所有患者中都是活动减少。与糖尿病患者相比,非糖尿病患者中一组危险因素在幸存者中出现的频率更高(p<0.05)。与非糖尿病患者相比,三种危险因素同时出现的情况在存活的糖尿病患者中更为常见(p<0.001)。尽管糖尿病患者中危险因素的总体存在率更高,但与非糖尿病患者相比,糖尿病患者中肺栓塞的患病率更低。一般来说,活动减少是肺栓塞发生的最重要危险因素,在糖尿病患者中肥胖也是。