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合并症对住院流感合并糖尿病患者死亡率的影响-奥地利健康保险分析。

Impact of comorbidities on mortality in hospitalized influenza patients with diabetes - Analysis of the Austrian Health Insurance.

机构信息

Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria.

Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria; Division of Exercise Physiology and Metabolism, University of Bayreuth, Bayreuth, Germany.

出版信息

Diabetes Res Clin Pract. 2021 Apr;174:108758. doi: 10.1016/j.diabres.2021.108758. Epub 2021 Mar 17.

Abstract

AIMS

To assess the impact of characteristics and comorbidities on the hospitalization rate and 30- and 90-days all-cause mortality after hospitalization for influenza-related illness (IRI) in individuals with diabetes.

METHODS

Data of 507,184 individuals with diabetes enrolled in the national Austrian Health Insurance database during 2013-2017 were analyzed. Hospitalization for IRI was defined as per International Classification of Disease 10 codes (J09, J10, J11). All-cause mortality was calculated for 30- and 90-days post-hospitalization.

RESULTS

Of the total diabetes population, 1994 (0.4%) were hospitalized for IRI during 2013-2017. The rate of comorbidities was higher in individiuals who were hospitalized due to IRI as compared with the general diabetes population. Overall 30-days cumulative mortality following hospitalization for IRI was 7.9% and 90-days mortality was 10.3%. The risk (adjusted Hazard Ratio, 95% Confidence Interval) of IRI related 90-days mortality increased with age (50-59: 3.00, 0.65-13.94; 60-69: 4.16, 0.99-17.55; 70-79: 4.79, 1.16-19.76; 80+: 7.15, 1.74-29.46), heart failure (1.97, 1.31-2.98), renal disease (1.50, 1.05-2.14), and Charlson comorbidity index (1.14, 1.08-1.19).

CONCLUSIONS

Older age, heart failure, renal disease, and Charlson comorbidity index were significant predictors of mortality following hospitalization for IRI in individuals with diabetes. These findings could help in improving the clinical management and performance of surveillance and health systems concerning IRI in Austria.

摘要

目的

评估特征和合并症对因流感相关疾病(IRI)住院的糖尿病患者的住院率以及 30 天和 90 天全因死亡率的影响。

方法

分析了 2013 年至 2017 年期间在奥地利国家健康保险数据库中登记的 507184 名糖尿病患者的数据。根据国际疾病分类第 10 版(J09、J10、J11)代码定义因 IRI 住院。计算了住院后 30 天和 90 天的全因死亡率。

结果

在糖尿病患者总人群中,2013 年至 2017 年期间有 1994 人(0.4%)因 IRI 住院。与普通糖尿病患者相比,因 IRI 住院的患者合并症发生率更高。总体而言,IRI 相关住院后 30 天累积死亡率为 7.9%,90 天死亡率为 10.3%。IRI 相关 90 天死亡率的风险(调整后的危害比,95%置信区间)随年龄增加而增加(50-59 岁:3.00,0.65-13.94;60-69 岁:4.16,0.99-17.55;70-79 岁:4.79,1.16-19.76;80 岁以上:7.15,1.74-29.46)、心力衰竭(1.97,1.31-2.98)、肾脏疾病(1.50,1.05-2.14)和 Charlson 合并症指数(1.14,1.08-1.19)。

结论

年龄较大、心力衰竭、肾脏疾病和 Charlson 合并症指数是糖尿病患者因 IRI 住院后死亡的重要预测因素。这些发现有助于改善奥地利有关 IRI 的临床管理和监测及卫生系统的表现。

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