Malabu Usman H, Adegboye Oyelola, Hayes Oliver G, Ryan Alexandra, Vangaveti Venkat N, Jhamb Shaurya, Robertson Kelvin, Sangla Kunwarjit S
The Townsville Hospital, Douglas, Queensland, Australia.
College of Medicine and Dentistry, James Cook University, Douglas, Queensland, Australia.
J Endocr Soc. 2020 Jan 31;4(2):bvaa009. doi: 10.1210/jendso/bvaa009. eCollection 2020 Feb 1.
To evaluate outcomes of diabetic inpatient hypoglycemia among Aboriginal and Torres Strait Islander (ATSI) compared with Australian Caucasian patients.
A retrospective audit of diabetic patients aged > 18 years admitted at a regional hospital general ward between April 1, 2015, and March 31, 2016, was analyzed. The database contains clinical information at the time of admission and initial discharge and readmission within 4 weeks thereafter.
A total of 1618 (of 6027) patients were admitted with diabetes representing 23.7% of the total ward admissions, of which 484 (29.9%) had inpatient hypoglycemia. Of the 91 patients with available data analyzed, ATSI origin with inpatient hypoglycemia was associated with longer length of stay (LOS) (hazard ratio [HR], 2.1, 95% confidence interval [CI], 1.2-3.5), whereas severe hypoglycemia (≤ 2.2 mmol/L) in both ATSI and non-ATSI was significantly associated with longer LOS (HR, 2.3; 95% CI, 1.2-4.2). No significant differences in LOS were found for gender, age, and Carlson comorbidity index (CCI). The adjusted model for likelihood of readmission, gender, indigenous status, and CCI were not significant risk factors for readmission to the hospital. Readmitted patients were older (50-59 years vs < 50 years, = 0.001; 60-69 years vs < 50 years, = 0.032; 70+ years vs < 50 years, = 0.031).
We reported high rate of inpatient hypoglycemia in our study population. Indigenous Australian diabetic patients with inpatient hypoglycemia had significantly longer LOS compared with non-Indigenous Caucasian counterparts. Further prospective studies on a larger population are needed to confirm our findings.
评估原住民和托雷斯海峡岛民（ATSI）糖尿病住院患者低血糖的结局，并与澳大利亚白种人患者进行比较。
对2015年4月1日至2016年3月31日期间在一家地区医院普通病房住院的18岁以上糖尿病患者进行回顾性审计分析。数据库包含入院时、初次出院时以及此后4周内再次入院时的临床信息。
共有1618名（共6027名）糖尿病患者入院，占病房总入院人数的23.7%，其中484名（29.9%）发生住院低血糖。在分析的91名有可用数据的患者中，有住院低血糖的ATSI患者住院时间较长（风险比[HR]为2.1，95%置信区间[CI]为1.2 - 3.5），而ATSI和非ATSI患者的严重低血糖（≤2.2 mmol/L）均与住院时间较长显著相关（HR为2.3；95%CI为1.2 - 4.2）。在性别、年龄和卡尔森合并症指数（CCI）方面，住院时间无显著差异。再入院可能性、性别、原住民身份和CCI的校正模型不是再次入院的显著危险因素。再次入院患者年龄较大（50 - 59岁与<50岁，P = 0.001；60 - 69岁与<50岁，P = 0.032；70岁及以上与<50岁，P = 0.031）。
我们的研究人群中住院低血糖发生率较高。与非原住民白种人糖尿病患者相比，患有住院低血糖的澳大利亚原住民糖尿病患者住院时间明显更长。需要对更多人群进行进一步的前瞻性研究以证实我们的发现。
