十年来高渗性高血糖状态的住院和住院死亡率。

Hospitalizations and inpatient mortality for hyperosmolar hyperglycemic state over a decade.

机构信息

Department of Internal Medicine, John H. Stroger Jr. Hospital, Chicago, IL, USA.

Department of Internal Medicine, Central Michigan University, Saginaw, MI, USA.

出版信息

Diabetes Res Clin Pract. 2022 Mar;185:109230. doi: 10.1016/j.diabres.2022.109230. Epub 2022 Feb 3.

DOI:10.1016/j.diabres.2022.109230

PMID:35122906

Abstract

OBJECTIVES

This study aimed to describe rates and trends in hospitalizations, inpatient mortality, total hospital charges, and mean lengths of stay among adult patients hospitalized for hyperosmolar hyperglycemic state (HHS).

METHODS

The study included NIS databases 2008, 2010, 2012, 2014, 2016, and 2018. These databases were searched for hospitalizations with a principal discharge diagnosis of HHS in patients with T2DM using ICD codes (25020, 25022, and E110). Patients less than 18 years, elective hospitalizations, HHS in patients with T1DM or secondary diabetes mellitus were excluded. We used multivariable regression analysis to obtain trends in mortality, length of stay (LOS), and total hospital charges (THC).

RESULTS

Between 2008 and 2018, there was a trend towards increasing hospitalizations for T2DM with HHS (p trend < 0.001). The mean age over the period ranged from 56.9 to 59.1 years old. Men made up the majority of hospitalizations. Over the decade, there was a steady rise in the proportion of Whites and Hispanics with HHS, and Medicare was the most prevalent insurer overall. Inpatient mortality for HHS decreased from 1.44% in 2008 to 0.77% in 2018 (p trend 0.007). There was also a statistically significant decrease in both LOS and THC over the studied period.

CONCLUSIONS

Trends in HHS showed increased hospitalizations, LOS, and THC over the decade in the study period, but inpatient mortality declined.

摘要

目的

本研究旨在描述成人高血糖高渗状态（HHS）住院患者的住院率、住院死亡率、总住院费用和平均住院时间的变化趋势。

方法

本研究纳入了 NIS 数据库 2008、2010、2012、2014、2016 和 2018 年的数据。使用 ICD 编码（25020、25022 和 E110），对这些数据库中患有 2 型糖尿病（T2DM）且主要出院诊断为 HHS 的住院患者进行了搜索。排除年龄小于 18 岁、择期住院、患有 1 型糖尿病（T1DM）或其他类型糖尿病的 HHS 患者。我们使用多变量回归分析来获得死亡率、住院时间（LOS）和总住院费用（THC）的变化趋势。

结果

在 2008 年至 2018 年期间，T2DM 合并 HHS 的住院人数呈上升趋势（趋势检验 p<0.001）。这期间患者的平均年龄在 56.9 至 59.1 岁之间，男性占多数。在这十年中，患有 HHS 的白人患者和西班牙裔患者的比例稳步上升，而医疗保险是最常见的保险类型。HHS 的住院死亡率从 2008 年的 1.44%下降至 2018 年的 0.77%（趋势检验 p=0.007）。在研究期间，LOS 和 THC 也呈显著下降趋势。