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2型糖尿病患者鼻中隔成形术后鼻中隔脓肿风险增加。

Increased Risk of Nasal Septal Abscess After Septoplasty in Patients with Type 2 Diabetes Mellitus.

作者信息

Luan Chih-Wei, Tsai Ming-Shao, Liu Chia-Yen, Yang Yao-Hsu, Tsai Yao-Te, Hsu Cheng-Ming, Wu Ching-Yuan, Chang Pey-Jium, Chang Geng-He

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Lo Sheng Sanatorium and Hospital Ministry of health and Welfare, Taipei, Taiwan.

Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

出版信息

Laryngoscope. 2021 Aug;131(8):E2420-E2425. doi: 10.1002/lary.29336. Epub 2020 Dec 16.

Abstract

OBJECTIVE/HYPOTHESIS: To investigate the risk of nasal septal abscess (NSA) in patients with type 2 diabetes mellitus (T2DM) after septoplasty.

STUDY DESIGN

Retrospective cohort study through Taiwan National Health Insurance database.

METHODS

The Taiwan National Health Insurance Research Database was used to conduct this retrospective cohort study. A total of 382 patients with T2DM (DM group) diagnosed between 2000 and 2010 and 382 matched patients without a DM diagnosis (non-DM group) were enrolled. Patients were followed up until death or December 31, 2013. NSA incidence was the main outcome.

RESULTS

After septoplasty, the cumulative incidence of NSA in the DM group was significantly higher than that in the non-DM group (P < .001). Cox proportional hazards regression indicated a significant association between T2DM and higher NSA incidence (adjusted hazard ratio, 2.62; 95% CI, 1.44-3.61; P < .001). However, subgroup analysis and sensitivity testing demonstrated that the effect of T2DM on NSA risk was stable. In addition, the subgroup with a Diabetes Complications Severity Index (DCSI) of ≥1 had higher NSA risk than that with DCSI = 0 (adjusted hazard ratio, 3.58; 95% CI, 2.10-6.09; P < .001). The treatment type for NSA did not differ between the groups.

CONCLUSIONS

T2DM is an independent risk factor for NSA in patients undergoing nasal septoplasty, and the NSA risk is greater among patients with high DM severity.

LEVEL OF EVIDENCE

IV Laryngoscope, 131:E2420-E2425, 2021.

摘要

目的/假设:探讨鼻中隔成形术后2型糖尿病(T2DM)患者发生鼻中隔脓肿(NSA)的风险。

研究设计

通过台湾国民健康保险数据库进行回顾性队列研究。

方法

使用台湾国民健康保险研究数据库进行这项回顾性队列研究。共纳入2000年至2010年间诊断为T2DM的382例患者(糖尿病组)和382例匹配的非糖尿病诊断患者(非糖尿病组)。对患者进行随访直至死亡或2013年12月31日。NSA发生率是主要结局。

结果

鼻中隔成形术后,糖尿病组NSA的累积发生率显著高于非糖尿病组(P <.001)。Cox比例风险回归表明T2DM与较高的NSA发生率之间存在显著关联(调整后的风险比为2.62;95%CI为1.44 - 3.61;P <.001)。然而,亚组分析和敏感性测试表明T2DM对NSA风险的影响是稳定的。此外,糖尿病并发症严重程度指数(DCSI)≥1的亚组NSA风险高于DCSI = 0的亚组(调整后的风险比为3.58;95%CI为2.10 - 6.09;P <.001)。两组间NSA的治疗类型无差异。

结论

T2DM是鼻中隔成形术患者发生NSA的独立危险因素,糖尿病严重程度高的患者NSA风险更大。

证据级别

IV 《喉镜》,131:E2420 - E2425,2021年。

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