Aldiabat Mohammad, Aljabiri Yazan, Kilani Yassine, Yusuf Mubarak H, Al-Khateeb Mohannad H, Horoub Ali, Farukhuddin Farukhuddin, Mahfouz Ratib, Obeidat Adham E
Internal Medicine/Geriatrics, NYU Langone Hospital, Mineola, USA.
Internal Medicine, New York City Health and Hospitals Corporation (NYCHHC) Lincoln Medical Center, New York City, USA.
Cureus. 2022 Sep 2;14(9):e28697. doi: 10.7759/cureus.28697. eCollection 2022 Sep.
Background Recent studies have shown an increased risk of diabetes mellitus in patients with Inflammatory bowel disease. However, the impact of IBD on outcomes of patients with diabetic ketoacidosis remains unknown. Methods This is an observational analysis of the National Inpatient Sample Database. The authors identified patients with a diagnosis of diabetic ketoacidosis and inflammatory bowel diseases. Outcomes studied were differences in risk of mortality, in-hospital outcomes and healthcare resources utilization. Multivariate logistic analysis was performed and results were adjusted for patient and hospital characteristics and comorbidities. Results No significant difference in mortality was observed in the DKA-IBD group when compared to the DKA-only group (aOR 0.55, p = 0.560). Similarly, inflammatory bowel disease had no impact on risk of sepsis (aOR 1.06, p = 0.742), acute kidney injury (aOR 1.08, p = 0.389), acute coronary syndrome (aOR 0.70, p = 0.397), ischemic stroke (aOR 1.53, p = 0.094), acute respiratory failure (aOR 1.00, p = 0.987), invasive mechanical ventilation (aOR 0.54, p = 0.225), deep vein thrombosis (aOR 1.68, p = 0.275), pulmonary embolism (aOR 2.16, p = 0.279) or cardiac arrest (aOR 1.35, p = 0.672) in diabetic ketoacidosis patients. The study group had a significant increase in length of stay (adjusted mean difference 0.63, p = 0.002) and charge of care (adjusted mean difference 3,950$, p = 0.026). Conclusion Inflammatory bowel disease is not associated with risk difference in mortality or morbidity in admitted patients with diabetic ketoacidosis, however, it does contribute to increased healthcare resources utilization.
背景 近期研究显示，炎症性肠病患者患糖尿病的风险增加。然而，炎症性肠病对糖尿病酮症酸中毒患者预后的影响仍不清楚。方法 这是一项对国家住院样本数据库的观察性分析。作者识别出诊断为糖尿病酮症酸中毒和炎症性肠病的患者。研究的结局包括死亡率风险、住院结局和医疗资源利用的差异。进行多因素逻辑分析，并对患者和医院特征及合并症进行结果调整。结果 与仅患有糖尿病酮症酸中毒的组相比，糖尿病酮症酸中毒合并炎症性肠病组的死亡率无显著差异（校正比值比0.55，p = 0.560）。同样，炎症性肠病对糖尿病酮症酸中毒患者发生脓毒症的风险（校正比值比1.06，p = 0.742）、急性肾损伤（校正比值比1.08，p = 0.389）、急性冠状动脉综合征（校正比值比0.70，p = 0.397）、缺血性卒中（校正比值比1.53，p = 0.094）、急性呼吸衰竭（校正比值比1.00，p = 0.987）、有创机械通气（校正比值比0.54，p = 0.225）、深静脉血栓形成（校正比值比1.68，p = 0.275）、肺栓塞（校正比值比2.16，p = 0.279）或心脏骤停（校正比值比1.35，p = 0.672）均无影响。研究组的住院时间显著延长（校正平均差异0.63，p = 0.002），护理费用增加（校正平均差异3950美元，p = 结论 炎症性肠病与入院的糖尿病酮症酸中毒患者的死亡率或发病率风险差异无关，但确实会导致医疗资源利用增加。
