Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.
Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.
Diabetologia. 2021 Jan;64(1):109-118. doi: 10.1007/s00125-020-05286-2. Epub 2020 Sep 28.
AIMS/HYPOTHESIS: Infection is an under-recognised but important complication in people with diabetes. Studies on temporal trends in incidence of infection in this population are limited. We report the trends in infection-related hospitalisation in people with diabetes and compared hospitalisation rates between people with and without diabetes in Hong Kong.
Hospital admissions with infection, including pneumonia, influenza, tuberculosis, kidney infection, urinary tract infection, cellulitis, osteomyelitis, foot infection and sepsis, listed as principal diagnosis occurring between 2001 and 2016 were identified from people with diabetes in the electronic medical record system of the Hong Kong Hospital Authority. Data on hospitalisation for a subset of these infections in the general population between 2007 and 2016 were obtained from the Department of Health. The number of people with diabetes ranged between 117,322 in 2001 and 570,929 in 2016, and the number without diabetes ranged between 5,242,614 in 2007 and 5,593,153 in 2016. Joinpoint regression was used to describe the trends.
In people with diabetes, over a period of 16 years, the age-standardised annual rates of hospitalisation decreased for tuberculosis but increased for influenza; rates of hospitalisation for pneumonia increased up until 2004/2005 and declined in men and stabilised in women. The rates of hospitalisation for most infection types were unchanged or increased in the 20-44 year and 45-64 year age groups and decreased in those aged 65 years or above. Trends for most of the infections were similar when comparing sexes. Between 2007 and 2016, the rate ratios of hospitalisation for most infection types between people with and without diabetes were stable, and the rate ratios remained higher in people with diabetes, ranging from 1.3-1.4 for pneumonia to 3.2-4.9 for kidney infections in 2016 compared with non-diabetic individuals.
CONCLUSIONS/INTERPRETATION: Despite advances in medical care, hospitalisation due to infections remains a major healthcare burden in people with diabetes. Graphical abstract.
目的/假设：感染是糖尿病患者中一个未被充分认识但很重要的并发症。关于该人群中感染发病率的时间趋势的研究有限。我们报告了糖尿病患者中与感染相关的住院治疗趋势，并比较了香港糖尿病患者和非糖尿病患者的住院率。
从香港医院管理局的电子病历系统中确定了 2001 年至 2016 年间因感染（包括肺炎、流感、结核病、肾脏感染、尿路感染、蜂窝织炎、骨髓炎、足部感染和败血症）而住院的患者，这些感染被列为主要诊断。从 2007 年至 2016 年期间，从卫生署获得了这些感染中一部分感染的住院数据。2001 年，糖尿病患者人数在 117322 人至 570929 人之间，2007 年，非糖尿病患者人数在 5242614 人至 5593153 人之间。使用 Joinpoint 回归描述趋势。
在 16 年的时间里，糖尿病患者的年龄标准化年住院率结核病下降，但流感上升；肺炎的住院率在 2004/2005 年之前上升，然后在男性中下降，在女性中稳定。在 20-44 岁和 45-64 岁年龄组中，大多数感染类型的住院率保持不变或增加，而在 65 岁或以上的人群中则下降。在比较性别时，大多数感染的趋势相似。在 2007 年至 2016 年期间，糖尿病患者与非糖尿病患者之间大多数感染类型的住院率比值保持稳定，且比值仍较高，2016 年时，糖尿病患者的比值在 1.3-1.4（肺炎）至 3.2-4.9（肾脏感染）之间，而非糖尿病患者的比值为 1。
结论/解释：尽管医疗保健取得了进步，但感染导致的住院治疗仍然是糖尿病患者的主要医疗保健负担。
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