Diabetes-related morbidity and mortality in a national sample of US elders
Diabetes-related morbidity and mortality in a national sample of US elders
复制标题
DOI：
10.2337/diacare.25.3.471
复制
发表时间：
2002-03-01
期刊：
影响因子：
16.2
通讯作者：
Brancati, FL
中科院分区：
文献类型：
--
作者：
Bertoni, AG;Anderson, GF;Brancati, FL
目的：尽管老年糖尿病患者的数量急剧增加，但关于老年糖尿病患者的死亡率和严重并发症的数据却很少。为了确定这一比率，我们使用1994-1996 Medicare 5%标准分析文件中的索赔数据进行了一项基于人群的非并发队列研究。研究设计和方法-使用ICD-9中的代码来识别糖尿病和下列并发症：截肢、下肢感染、坏疽、失明、急性心肌梗死、缺血性心脏病、中风和代谢紊乱。使用这些代码，我们收集了一个队列，其中包括148,562名大于或等于65岁的联邦医疗保险A部分和B部分受益人，他们在1995年1月1日还活着，1994年不在管理性医疗中，以及1994年有糖尿病相关索赔。然后计算年龄相关的死亡率和并发症。结果：在24个月的随访中，22,044名老年糖尿病患者死亡(14.8%)。男性和女性的死亡率随着年龄的增长而显著增加。与美国普通人群相比，患有糖尿病的老年人在每个年龄组都遭受了超额死亡率，对应的总体标准化死亡率为1.41(95%可信区间1.39，1.43)。缺血性心脏病和中风的发病率分别为181.5/千人年和126.2/千人年，高于所有其他糖尿病相关并发症的发生率。结论：在各个年龄段，老年糖尿病患者的全因死亡率明显高于普通人群。医疗保险数据可能有助于监测美国老年糖尿病患者与糖尿病相关的发病率和总死亡率的趋势。
Objective-Although the number of elders with diabetes has increased dramatically, there are few data on rates of mortality and serious complications in older populations with diabetes. To determine such rates, we conducted a population-based, nonconcurrent cohort study using claims data from the 1994-1996 Medicare 5% Standard Analytical File.Research Design and Methods-Codes from the ICD-9 were used to identify diabetes and the following complications: amputation, lower extremity infection, gangrene, blindness, acute myocardial infarction, ischemic heart disease, stroke and metabolic disorders. Using these codes, we assembled a cohort of 148,562 Medicare Part A and B beneficiaries who were greater than or equal to65 years of age, who were alive on 1 January 1995, who were not in managed care in 1994, and who had a diabetes-related claim in 1994. Age-specific rates of death and complications were then calculated.Results-During 24 months of follow-up, 22,044 (14.8%) elders with diabetes died. Death rates in men and women increased significantly with age. Compared with their counterparts in the general U.S. population, elders with diabetes suffered excess mortality at every age group, corresponding to an overall standardized mortality ratio of 1.41 (95% CI 1.39, 1.43). The incidence of ischemic heart disease and stroke was 181.5 and 126.2 per 1,000 person-years, respectively, which was higher than the incidence of all other diabetes-related complications.Conclusions-In every age group, elders with diabetes have significantly higher all-cause mortality rates than the general population. Medicare data may be useful in monitoring trends in diabetes-related morbidity and total mortality in U.S. elders with diabetes.