Longitudinal Trends in the Prevalence of Diabetes Mellitus in an Urban Emergency Department.
Longitudinal Trends in the Prevalence of Diabetes Mellitus in an Urban Emergency Department.
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DOI：
10.14423/smj.0000000000000447
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发表时间：
2016-04
影响因子：
1.1
通讯作者：
Cox RD
中科院分区：
文献类型：
--
作者：
Sterling SA;Jones AE;Cox RD
本研究的目的是探讨急诊科（艾德）患者糖尿病（DM）的纵向趋势，并评估与这些趋势相关的因素。我们对2006年至2011年到艾德就诊的所有患者进行了回顾性分析。前瞻性记录DM的存在、身高和体重。该研究在一家城市学术医院的艾德急诊室进行，平均年患者量约为62，000例。入选标准为年龄≥ 16岁;因任何原因就诊于艾德;记录身高、体重和DM病史。在1年区组中分析数据，然后使用线性回归分析检查趋势。还按肥胖类别检查了数据：正常（体重指数[BMI] 20-24.9 kg/m2）、超重（BMI 25-29.9 kg/m2）、肥胖（BMI 30-39.9 kg/m2）和极度肥胖（BMI >40 kg/m2）。在研究期间，2型糖尿病的患病率在统计学上显著增加。所有患者访视的2型DM百分比从10.7%逐渐增加至16.1%（r2 0.97）。在所有BMI等级中观察到2型糖尿病的年患病率逐渐增加。DM增加的变化率与肥胖程度直接相关。对于正常体重类别，DM患者百分比每年增加0.5%（r2 0.92），超重患者百分比每年增加0.7%（r2 0.88），肥胖患者百分比每年增加1.0%（r2 0.90），极度肥胖患者百分比每年增加1.4%（r2 0.94）。所有肥胖组的患者年龄略有增加，导致人群中DM患病率每年增加0.2%至0.4%。在纵向分析中，我们发现糖尿病患者的患病率增加，糖尿病患者的艾德就诊率增加。我们的研究结果表明，这些增加的影响最显着的肥胖水平的病人。
The objective of this study was to examine the longitudinal trends in diabetes mellitus (DM) in emergency department (ED) patients and evaluate the factors associated with those trends. We conducted a retrospective analysis of all patients who presented to the ED from 2006 to 2011. The presence of DM, height, and weight were recorded prospectively. The study was conducted in the ED of an urban, academic hospital with an average yearly volume of approximately 62,000 patients. Inclusion criteria were age 16 years and older; presentation to the ED for any reason; and documentation of height, weight, and history of DM. Data were analyzed in 1-year blocks, then examined for trends using linear regression analysis. Data also were examined by obesity class: normal (body mass index [BMI] 20–24.9 kg/m2), overweight (BMI 25–29.9 kg/m2), obese (BMI 30–39.9 kg/m2), and extreme obesity (BMI >40 kg/m2). There was a statistically significant increase in the prevalence of type 2 DM during the study period. The percentage of type 2 DM for all patient visits increased progressively from 10.7% to 16.1% (r2 0.97). Progressive increases in yearly type 2 DM prevalence were observed for all BMI classes. The rate of change in the increase of DM was related directly to the degree of obesity. For the normal weight category, the percentage of patients with DM increased 0.5%/year (r2 0.92), overweight 0.7%/year (r2 0.88), obesity 1.0%/year (r2 0.90), and extreme obesity category 1.4%/year (r2 0.94). Patient age increased slightly for all obesity groups, accounting for a 0.2% to 0.4%/year increase in the prevalence of DM in the population. In this longitudinal analysis, we found an increase in the prevalence of patients with DM and an increase in ED visits by patients with DM. Our results indicate that these increases are influenced most significantly by the obesity level of the patient.