Currie C J, Morgan C L, Peters J R
Department of Public Health Medicine, Bro Taf Health Authority, U.K.
Diabetes Care. 1998 Jan;21(1):42-8. doi: 10.2337/diacare.21.1.42.
To describe the epidemiology and costs of the acute care of peripheral vascular disease, infection, neuropathy, and ulceration in a U.K. population with special consideration of those patients with diabetes.
Routine data describing inpatient care for a 4-year period were analyzed (financial years 1991/1992 to 1994/1995). These data had undergone record-linkage to draw together records from the same patients, and records of patients with diabetes were flagged. Cost estimates were determined by attributing a diagnosis-related group cost-weight to each record.
A total of 4,245 admissions (1.2% of all admissions) had a primary diagnosis of peripheral vascular disease, infection, neuropathy, or ulceration, and 7,379 (2.1%) admissions had these categories recorded in any one of six diagnostic fields. These figures were generated by 3,159 and 4,751 patients, respectively. This represented a range of crude annual incidence of admission of between 1.9 and 2.9 per 1,000 people. Patients with diabetes accounted for 625 (15.4%) of primary admissions, a crude annual incidence of admission of 18.8 per 1,000. The age-standardized relative risk of admission for patients with diabetes to the nondiabetic population was 7.61 for men and 6.85 for women. The length of stay for patients with diabetes was almost twice that of the nondiabetic population (15.5 vs. 8.7 days). The relative risk of hospital mortality (diabetes vs. non-diabetes) was 2.83. Surgical procedures were carried out on 857 patients, 272 (31.2%) with diabetes. This represented an age-standardized relative risk of 31.19. The estimated cost of admissions for primary diagnoses in these categories over 4 years was 6,128,211 pounds ($9,743,855). Patients with diabetes accounted for 1,236,623 pounds ($1,966,230), an excess of 87% attributable to the diabetic state.
Diabetes is confirmed as a significant risk factor for peripheral vascular disease, infection, neuropathy, and ulceration. The severity of these disorders in terms of increased risk of hospital mortality, length of stay, and risk of surgical procedure is also demonstrated for those patients with diabetes.
描述英国人群外周血管疾病、感染、神经病变和溃疡的急性护理的流行病学情况及成本，特别考虑糖尿病患者。
分析了描述4年期间住院护理情况的常规数据（1991/1992财政年度至1994/1995财政年度）。这些数据经过记录链接，汇总来自同一患者的记录，并标记出糖尿病患者的记录。成本估计通过为每条记录赋予一个诊断相关组成本权重来确定。
共有4245例入院患者（占所有入院患者的1.2%）的主要诊断为外周血管疾病、感染、神经病变或溃疡，7379例（占2.1%）入院患者在六个诊断领域中的任何一个领域记录有这些类别。这些数字分别由3159名和4751名患者产生。这代表了每年每1000人中入院的粗发病率在1.9至2.9之间。糖尿病患者占主要入院患者的625例（15.4%），每年每1000人的入院粗发病率为18.8。糖尿病患者相对于非糖尿病人群的年龄标准化入院相对风险，男性为7.61，女性为6.85。糖尿病患者的住院时间几乎是非糖尿病人群的两倍（15.5天对8.7天）。医院死亡率的相对风险（糖尿病患者对非糖尿病患者）为2.83。对857名患者进行了外科手术，其中272名（31.2%）患有糖尿病。这代表年龄标准化相对风险为31.19。这4年中这些类别的主要诊断入院估计成本为6128211英镑（9743855美元）。糖尿病患者占1236623英镑（1966230美元），因糖尿病状态导致的超额成本为87%。
糖尿病被确认为外周血管疾病、感染、神经病变和溃疡的重要危险因素。对于糖尿病患者，这些疾病在医院死亡率增加、住院时间延长和手术风险方面的严重程度也得到了证实。
