Panuda Jose Paolo, Macalalad-Josue Anna Angelica, Buenaluz-Sedurante Myrna
Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of the Philippines-Philippine General Hospital.
J ASEAN Fed Endocr Soc. 2019;34(1):36-43. doi: 10.15605/jafes.034.01.07. Epub 2019 Mar 21.
To determine the factors associated with in-hospital mortality among diabetic patients admitted for lower extremity infection.
This is a retrospective analysis of diabetic patients with lower extremity infection admitted at the UPPhilippine General Hospital. Data was analyzed through multiple logistic regression after multiple imputation was performed for missing data.
441 patients with diabetes were included in the analysis, of which 98.1% have Type 2 diabetes mellitus; 58.1% were males and the mean age of the cohort was 56.7±11.1 years. The mortality rate was 11.1% over the 3-year period from 2015 to 2017, of which 46% died from myocardial infarction (MI). Multivariate logistic regression showed the following were associated with increased likelihood of in-hospital mortality: non-performance of surgery (OR=4.22, 95%CI 1.10-16.27, =0.036), elevated BUN (OR=1.06, 95%CI 1.01-1.11, =0.016), MI (OR=27.19, 95%CI 6.38-115.94, =0.000), respiratory failure requiring mechanical ventilation (OR=26.14, 95%CI 6.28-108.80, =0.000), gastrointestinal bleeding (OR=10.08, 95%CI 1.87-54.38, =0.007), hospital-acquired pneumonia (OR=9.46, 95%CI 2.52-35.51, =0.001) and shock (OR=7.09, 95%CI 2.17-23.22, =0.001).
In the in-patient setting, morbidity and mortality is high among diabetic patients with lower extremity infection. Non-performance of surgery, elevated BUN, MI, respiratory failure requiring mechanical ventilation, gastrointestinal bleeding, hospital acquired pneumonia and shock are associated with in-hospital death.
确定因下肢感染入院的糖尿病患者院内死亡的相关因素。
这是对菲律宾大学菲律宾总医院收治的下肢感染糖尿病患者的回顾性分析。对缺失数据进行多重插补后，通过多重逻辑回归分析数据。
441例糖尿病患者纳入分析，其中98.1%为2型糖尿病；58.1%为男性，队列平均年龄为56.7±11.1岁。2015年至2017年的3年期间死亡率为11.1%，其中46%死于心肌梗死（MI）。多因素逻辑回归显示，以下因素与院内死亡可能性增加相关：未进行手术（比值比[OR]=4.22，95%置信区间[CI]1.10 - 16.27，P=0.036）、血尿素氮（BUN）升高（OR=1.06，95%CI 1.01 - 1.11，P=0.016）、MI（OR=27.19，95%CI 6.38 - 115.94，P=0.000）、需要机械通气的呼吸衰竭（OR=26.14，95%CI 6.28 - 108.80，P=0.000）、胃肠道出血（OR=10.08，95%CI 1.87 - 54.38，P=0.007）、医院获得性肺炎（OR=9.46，95%CI 2.52 - 35.51，P=0.001）和休克（OR=7.09，95%CI 2.17 - 23.22，P=0.001）。
在住院患者中，下肢感染的糖尿病患者发病率和死亡率较高。未进行手术、BUN升高、MI、需要机械通气的呼吸衰竭、胃肠道出血、医院获得性肺炎和休克与院内死亡相关。
