Gunasekaran Kulothungan, Murthi Swetha, Elango Kalaimani, Rahi Mandeep Singh, Thilagar Bright, Ramalingam Sathishkumar, Voruganti Dinesh, Paramasivam Vijaya Kumar, Kolandaivel Krishna Prasad, Arora Ashish, Chandran Arul
Division of Pulmonary Diseases and Critical Care, Yale-New Haven Health Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610, USA.
Division of Endocrinology and Metabolism, Lenox Hill Hospital, 110 e 59th Street, New York, NY 10022, USA.
J Clin Med. 2021 Jan 11;10(2):235. doi: 10.3390/jcm10020235.
(1) Background: Chronic obstructive pulmonary disease (COPD) is the leading cause of morbidity and mortality worldwide. Diabetes mellitus (DM) has been shown to have adverse inflammatory effects on lung anatomy and physiology. We investigated the impact of DM on COPD patient outcomes during inpatient hospitalization. (2) Methods: We conducted a retrospective analysis using the Nationwide Inpatient Sample (NIS) over the years 2002-2014. Three groups, COPD without diabetes, COPD with diabetes but no complication, and COPD with DM and complication, were analyzed. (3) Results: A total of 7,498,577 were COPD hospitalization; of those, 1,799,637 had DM without complications, and 483,467 had DM with complications. After adjusting for clinical, demographic, and comorbidities, the odds of increased LOS in the COPD/DM with complication were 1.37 (confidence interval (CI): 1.326-1.368), and those of DM without complication were 1.061 (1.052-1.070) when compared with COPD alone. The odds of pneumonia, respiratory failure, stroke, and acute kidney injury were also higher in COPD hospitalizations with DM. Both DM with complication (odds ratio (OR): 0.751 (CI 0.727-0.777)) and DM without complication (OR: 0.635 (CI: 0.596-0.675)) have lesser odds of mortality during hospitalization than with COPD alone. (4) Conclusions: There is a considerable inpatient burden among COPD patients with DM in the United States.
（1）背景：慢性阻塞性肺疾病（COPD）是全球发病和死亡的主要原因。糖尿病（DM）已被证明对肺部解剖结构和生理功能有不良炎症影响。我们调查了糖尿病对慢性阻塞性肺疾病患者住院期间预后的影响。（2）方法：我们使用2002年至2014年的全国住院患者样本（NIS）进行了回顾性分析。分析了三组：无糖尿病的慢性阻塞性肺疾病患者、患有糖尿病但无并发症的慢性阻塞性肺疾病患者以及患有糖尿病且有并发症的慢性阻塞性肺疾病患者。（3）结果：共有7498577例慢性阻塞性肺疾病住院病例；其中，1799637例患有无并发症的糖尿病，483467例患有糖尿病且有并发症。在调整了临床、人口统计学和合并症因素后，与单纯慢性阻塞性肺疾病相比，患有并发症的慢性阻塞性肺疾病/糖尿病患者住院时间延长的几率为1.37（置信区间（CI）：1.326 - 1.368），无并发症的糖尿病患者为1.061（1.052 - 1.070）。慢性阻塞性肺疾病合并糖尿病的住院患者发生肺炎、呼吸衰竭、中风和急性肾损伤的几率也更高。患有并发症的糖尿病（比值比（OR）：0.751（CI 0.727 - 0.777））和无并发症的糖尿病（OR：0.635（CI：0.596 - 0.675））在住院期间的死亡几率均低于单纯慢性阻塞性肺疾病患者。（4）结论：在美国，患有糖尿病的慢性阻塞性肺疾病患者存在相当大的住院负担。
