Suppr超能文献

严重低血糖需住院治疗对 1 型糖尿病患者死亡率的影响:一项全国性回顾性观察队列研究。

Impact of severe hypoglycaemia requiring hospitalization on mortality in people with type 1 diabetes: A national retrospective observational cohort study.

机构信息

Division Exercise Physiology and Metabolism, Department of Sport Science, University of Bayreuth, Bayreuth, Germany.

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

出版信息

Diabetes Obes Metab. 2023 Aug;25(8):2243-2254. doi: 10.1111/dom.15102. Epub 2023 May 4.

Abstract

AIMS

To assess if the risk of all-cause mortality increases in people with type 1 diabetes (T1D) with increasing number of severe hypoglycaemia episodes requiring hospitalization.

MATERIALS AND METHODS

We conducted a national retrospective observational cohort study in people with T1D (diagnosed between 2000 and 2018). Clinical, comorbidity and demographic variables were assessed for impact on mortality for people with no, one, two and three or more episodes of severe hypoglycaemia requiring hospitalization. The time to death (all-cause mortality) from the timepoint of the last episode of severe hypoglycaemia was modelled using a parametric survival model.

RESULTS

A total of 8224 people had a T1D diagnosis in Wales during the study period. The mortality rate (95% confidence interval [CI]) was 6.9 (6.1-7.8) deaths/ 1000 person-years (crude) and 15.31 (13.3-17.63) deaths/ 1000 person-years (age-adjusted) for those with no occurrence of severe hypoglycaemia requiring hospitalization. For those with one episode of severe hypoglycaemia requiring hospitalization the mortality rate (95% CI) was 24.9 (21.0-29.6; crude) and 53.8 (44.6-64.7) deaths/ 1000 person-years (age-adjusted), for those with two episodes of severe hypoglycaemia requiring hospitalization it was 28.0 (23.1-34.0; crude) and 72.8 (59.2-89.5) deaths/ 1000 person-years (age-adjusted), and for those with three or more episodes of severe hypoglycaemia requiring hospitalization it was 33.5 (30.0-37.3; crude) and 86.3 (71.7-103.9) deaths/ 1000 person years (age-adjusted; P < 0.001). A parametric survival model showed that having two episodes of severe hypoglycaemia requiring hospitalization was the strongest predictor for time to death (accelerated failure time coefficient 0.073 [95% CI 0.009-0.565]), followed by having one episode of severe hypoglycaemia requiring hospitalization (0.126 [0.036-0.438]) and age at most recent episode of severe hypoglycaemia requiring hospitalization (0.917 [0.885-0.951]).

CONCLUSIONS

The strongest predictor for time to death was having two or more episodes of severe hypoglycaemia requiring hospitalization.

摘要

目的

评估因严重低血糖需住院治疗的发作次数增加,1 型糖尿病(T1D)患者全因死亡率的风险是否增加。

材料和方法

我们在 T1D 患者中进行了一项全国性回顾性观察队列研究(2000 年至 2018 年间确诊)。评估了无、1 次、2 次和 3 次或更多次因严重低血糖需住院治疗的发作次数对死亡率的影响。使用参数生存模型来评估从最后一次严重低血糖发作到死亡(全因死亡率)的时间。

结果

在研究期间,威尔士共有 8224 人被诊断出患有 T1D。无严重低血糖需住院治疗的患者死亡率(95%置信区间[CI])为 6.9(6.1-7.8)例/1000 人年(粗率)和 15.31(13.3-17.63)例/1000 人年(年龄调整后)。因严重低血糖需住院治疗发作 1 次的患者死亡率(95%CI)为 24.9(21.0-29.6;粗率)和 53.8(44.6-64.7)例/1000 人年(年龄调整后),因严重低血糖需住院治疗发作 2 次的患者死亡率为 28.0(23.1-34.0;粗率)和 72.8(59.2-89.5)例/1000 人年(年龄调整后),因严重低血糖需住院治疗发作 3 次或更多次的患者死亡率为 33.5(30.0-37.3;粗率)和 86.3(71.7-103.9)例/1000 人年(年龄调整后;P<0.001)。参数生存模型显示,因严重低血糖需住院治疗发作 2 次是死亡时间的最强预测因素(加速失效时间系数 0.073[95%CI 0.009-0.565]),其次是因严重低血糖需住院治疗发作 1 次(0.126[0.036-0.438])和最近一次因严重低血糖需住院治疗的年龄(0.917[0.885-0.951])。

结论

死亡时间的最强预测因素是因严重低血糖需住院治疗发作 2 次或更多次。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验