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糖尿病相关住院患者再入院和死亡的预测因素

Predictors of Rehospitalization and Mortality in Diabetes-Related Hospital Admissions.

作者信息

Kozioł Milena, Towpik Iwona, Żurek Michał, Niemczynowicz Jagoda, Wasążnik Małgorzata, Sanchak Yaroslav, Wierzba Waldemar, Franek Edward, Walicka Magdalena

机构信息

Department of Analyses and Strategies, Polish Ministry of Health, 00-952 Warsaw, Poland.

Department of Internal Diseases, Collegium Medicum, University of Zielona Góra, 65-046 Zielona Góra, Poland.

出版信息

J Clin Med. 2021 Dec 12;10(24):5814. doi: 10.3390/jcm10245814.

Abstract

The risk factors of rehospitalization and death post-discharge in diabetes-related hospital admissions are not fully understood. To determine them, a population-based retrospective epidemiological survey was performed on diabetes-related admissions from the Polish national database. Logistic regression models were used, in which the dependent variables were rehospitalization due to diabetes complications and death within 90 days after the index hospitalization. In 2017, there were 74,248 hospitalizations related to diabetes. A total of 11.3% ended with readmission. Risk factors for rehospitalization were as follows: age < 35 years; male sex; prior hospitalization due to acute diabetic complications; weight loss; peripheral artery disease; iron deficiency anemia; kidney failure; alcohol abuse; heart failure; urgent, emergency, or weekend admission; length of hospitalization; and hospitalization in a teaching hospital with an endocrinology/diabetology unit. Furthermore, 7.3% of hospitalizations resulted in death within 90 days following discharge. Risk factors for death were as follows: age; neoplastic disease with/without metastases; weight loss; coagulopathy; alcohol abuse; acute diabetes complications; heart failure; kidney failure; iron deficiency anemia; peripheral artery disease; fluid, electrolytes, and acid-base balance disturbances; urgent or emergency and weekend admission; and length of hospitalization. We concluded that of all investigated factors, only hospitalization within an experienced specialist center may reduce the frequency of the assessed outcomes.

摘要

糖尿病相关住院患者出院后再次住院和死亡的风险因素尚未完全明确。为了确定这些因素,我们基于波兰国家数据库对糖尿病相关住院病例进行了一项基于人群的回顾性流行病学调查。我们使用了逻辑回归模型,其中因变量为糖尿病并发症导致的再次住院以及首次住院后90天内的死亡情况。2017年,共有74248例与糖尿病相关的住院病例。其中11.3%的病例以再次入院告终。再次住院的风险因素如下:年龄<35岁;男性;既往因急性糖尿病并发症住院;体重减轻;外周动脉疾病;缺铁性贫血;肾衰竭;酗酒;心力衰竭;紧急、急诊或周末入院;住院时间;以及在设有内分泌/糖尿病科的教学医院住院。此外,7.3%的住院病例在出院后90天内死亡。死亡的风险因素如下:年龄;有/无转移的肿瘤性疾病;体重减轻;凝血病;酗酒;急性糖尿病并发症;心力衰竭;肾衰竭;缺铁性贫血;外周动脉疾病;液体、电解质和酸碱平衡紊乱;紧急或急诊及周末入院;以及住院时间。我们得出结论,在所有调查因素中,只有在经验丰富的专科中心住院可能会降低所评估结局发生的频率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2694/8704926/7c52a963716a/jcm-10-05814-g001.jpg

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