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约旦 2 型糖尿病患者的死亡率预测因素。

Predictors of mortality among patients with type 2 diabetes in Jordan.

机构信息

Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, 3030, Irbid, 22110, Jordan.

Princess Muna Heart Institute, King Abdullah University Hospital, Division of Cardiac Surgery, Department of General Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.

出版信息

BMC Endocr Disord. 2021 Oct 12;21(1):200. doi: 10.1186/s12902-021-00866-8.

Abstract

BACKGROUND

Diabetes Mellitus (DM) is a common metabolic disease associated with increased risk of mortality.

OBJECTIVE

The aim of this study was to examine predictors of mortality among patients with type 2 diabetes in the north of Jordan.

METHODS

Electronic data files for diabetes patients admitted between the period of 2014-2018 at a tertiary center in the north of Jordan were reviewed. Patient's characteristics, clinical and laboratory data, use of medications and mortality rate were collected.

RESULTS

Mean age of patients (n = 957) was 60.99 ± 0.37 (mean ± sem). Most of patients had multiple risk factors and underlying cardiovascular diseases (CVDs). Mortality rate was 10.1%. Univariate predictors of mortality included age, chronic kidney disease (CKD), acute kidney injury, hypertension, heart failure (HF), coronary artery disease, venous thromboembolism (VTE), stroke, atrial fibrillation (AF), and chronic obstructive pulmonary disease (COPD). As the number of CVDs increases, mortality rate also increases (Odd ratio 2.0, p < 0.0001). Use of insulin, aspirin, ACEi/ARBS, beta blockers, and diuretics were also associated with mortality. Fasting glucose and percentage of glycated hemoglobin were not associated with mortality. By multivariable logistic regression analysis adjusting for confounders and collinearity; age, HF, AF, COPD, VTE, and CKD were associated with mortality.

CONCLUSION

Key risk factors of mortality are CVDs and CKD indicating that the primary step of management should focus on optimizing risk factors to prevent diabetes complications and death.

摘要

背景

糖尿病(DM)是一种常见的代谢疾病,与死亡率增加相关。

目的

本研究旨在探讨约旦北部 2 型糖尿病患者死亡的预测因素。

方法

回顾了 2014 年至 2018 年期间在约旦北部一家三级中心住院的糖尿病患者的电子数据文件。收集了患者的特征、临床和实验室数据、药物使用情况和死亡率。

结果

患者(n=957)的平均年龄为 60.99±0.37(平均值±标准误差)。大多数患者有多种危险因素和潜在的心血管疾病(CVDs)。死亡率为 10.1%。死亡的单因素预测因素包括年龄、慢性肾脏病(CKD)、急性肾损伤、高血压、心力衰竭(HF)、冠状动脉疾病、静脉血栓栓塞(VTE)、中风、心房颤动(AF)和慢性阻塞性肺疾病(COPD)。随着 CVD 数量的增加,死亡率也随之增加(优势比 2.0,p<0.0001)。使用胰岛素、阿司匹林、ACEi/ARBs、β受体阻滞剂和利尿剂也与死亡率相关。空腹血糖和糖化血红蛋白百分比与死亡率无关。通过多变量逻辑回归分析调整混杂因素和共线性;年龄、HF、AF、COPD、VTE 和 CKD 与死亡率相关。

结论

死亡的关键危险因素是 CVDs 和 CKD,这表明管理的首要步骤应侧重于优化危险因素,以预防糖尿病并发症和死亡。

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