Excess mortality during hospital stays among patients with recorded diabetes compared with those without diabetes
Excess mortality during hospital stays among patients with recorded diabetes compared with those without diabetes
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DOI：
10.1111/dme.12282
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发表时间：
2013-12-01
影响因子：
3.5
通讯作者：
Young, R. J.
中科院分区：
文献类型：
--
作者：
Holman, N.;Hillson, R.;Young, R. J.
AimTo评估额外的死亡率在住院期间记录糖尿病患者，并确定在英语供应商trusts.MethodsInpatient入院的变化程度之间的所有英语医院2010年4月至2012年3月，从医院发作统计。二元逻辑回归用于标准化年龄，性别，剥夺，方法和入院原因，共病和信任类型。信任水平的标准化死亡率与记录的糖尿病住院患者相比，没有记录的糖尿病和公布的措施，医院mortality.ResultsOf 10169003入院分析，11.2%的记录糖尿病，但21.5%的住院死亡发生在这一组。在调整病例组合后，与无糖尿病记录的类似患者相比，有糖尿病记录的患者的住院死亡风险高6.4%（2052年多死亡2052人）。在较小的信托中，死亡的额外风险明显更大。最高的额外死亡风险被发现在住院的年轻女性患者选择承认。在供应商的信任水平，37.4%的变化，在调整后的死亡率与记录糖尿病患者的死亡率在那些没有记录diabetes.ConclusionA糖尿病的诊断有不良影响，不能解释通常的情况下，组合调整医院的死亡率，死亡的额外风险是最大的入院，通常会有一个低的死亡风险。这意味着糖尿病可能超过医院死亡率的通常风险因素。
AimTo assess the additional mortality during hospital admissions among patients with recorded diabetes and identify the extent of variation in English provider trusts.MethodsInpatient admissions to all English hospitals between April 2010 and March 2012 were extracted from Hospital Episode Statistics. Binary logistic regression was used to standardize for age, sex, deprivation, method and reason for admission, co-morbidities and type of trust. Trust level standardized mortality ratios for inpatients with recorded diabetes were compared with those without recorded diabetes and with published measures of hospital mortality.ResultsOf the 10169003 hospital admissions analysed, 11.2% had recorded diabetes, but 21.5% of inpatient deaths occurred in this group. After adjustment for case mix, hospital admissions in patients with recorded diabetes had a 6.4% greater risk of dying (2052 more deaths over 2years) than would be expected compared with similar patients without recorded diabetes. The additional risk of death was significantly greater in smaller trusts. The highest additional risk of death was found in hospital admissions of younger female patients admitted electively. At provider trust level, 37.4% of variation in adjusted mortality in patients with recorded diabetes was explained by the mortality in those without recorded diabetes.ConclusionA diagnosis of diabetes has an adverse impact on hospital mortality that cannot be explained by usual case-mix adjustments, and the additional risk of dying is greatest among hospital admissions that would normally have a low risk of death. This implies that diabetes may override the usual risk factors for hospital mortality.