Dept of Internal Medicine and Infectious Diseases, University Hospital of Patras, Greece.
Nafpaktos Primary Care Unit, Nafpaktos, Greece.
J Diabetes Complications. 2021 Jan;35(1):107765. doi: 10.1016/j.jdiacomp.2020.107765. Epub 2020 Oct 9.
We sought to determine whether primary outcomes differ between non-ICU septic patients with and without type 2 diabetes (T2D).
This study utilized the Hellenic Sepsis Study Group Registry, collecting nationwide data for sepsis patients since 2006, and classified patients upon presence or absence of T2D. Patients were perfectly matched for a) Sepsis 3 definition criteria (including septic shock) b) gender, c) age, d) APACHE II score and e) Charlson's comorbidity index (CCI). Independent sample t-test and chi-square t-test was used to compare prognostic indices and primary outcomes.
Of 4320 initially included non-ICU sepsis patients, 812 were finally analysed, following match on criteria. Baseline characteristics were age 76 [±10.3] years, 46% male, APACHE II 15.5 [±6], CCI 5.1 [±1.8], 24% infection, 63.8% sepsis and 12.2% septic shock. No significant difference was noted between two groups in qSOFA, SOFA, or suPAR1 levels (p = 0.7, 0.1 & 0.3) respectively. Primary sepsis syndrome resolved in 70.9% of cases (p = 0.9), while mortality was 24% in 28-days time. Cause of death was similar between patients with and without T2D (sepsis 17.8% vs 15.8%, heart event 3.7% vs 3.2%, CNS event 0.5% vs 0.5%, malignancy 0.7% vs 2% respectively, p = 0.6).
DM does not appear to negatively affect outcomes in septic patients not requiring ICU.
我们旨在确定患有 2 型糖尿病（T2D）与不患有 T2D 的非 ICU 脓毒症患者的主要结局是否存在差异。
本研究利用希腊脓毒症研究组注册中心，自 2006 年起收集全国脓毒症患者的数据，并根据是否存在 T2D 对患者进行分类。患者根据以下标准进行完全匹配：a）Sepsis 3 定义标准（包括感染性休克）b）性别、c）年龄、d）APACHE II 评分和 e）Charlson 合并症指数（CCI）。采用独立样本 t 检验和卡方检验比较预后指标和主要结局。
在最初纳入的 4320 例非 ICU 脓毒症患者中，最终有 812 例患者符合纳入标准并进行了分析。患者的基线特征为年龄 76 [±10.3] 岁，46%为男性，APACHE II 评分为 15.5 [±6]，CCI 为 5.1 [±1.8]，24%有感染，63.8%为脓毒症，12.2%为感染性休克。两组间 qSOFA、SOFA 或 suPAR1 水平无显著差异（p 值分别为 0.7、0.1 和 0.3）。70.9%的患者主要脓毒症综合征得到缓解（p 值=0.9），28 天死亡率为 24%。患有 T2D 与不患有 T2D 的患者的死亡原因相似（脓毒症分别为 17.8%和 15.8%，心脏事件分别为 3.7%和 3.2%，中枢神经系统事件分别为 0.5%和 0.5%，恶性肿瘤分别为 0.7%和 2%，p 值=0.6）。
在不需要 ICU 治疗的脓毒症患者中，糖尿病似乎不会对结局产生负面影响。
