Risk factors for mortality among patients with diabetes - The Translating Research Into Action for Diabetes (TRIAD) Study
Risk factors for mortality among patients with diabetes - The Translating Research Into Action for Diabetes (TRIAD) Study
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DOI：
10.2337/dc07-0305
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发表时间：
2007-07-01
期刊：
影响因子：
16.2
通讯作者：
Herman, William H.
中科院分区：
文献类型：
--
作者：
McEwen, Laura N.;Kim, Catherine;Herman, William H.
目的-我们试图研究人口统计学，社会经济学和生物学预测的全因，心血管和非心血管死亡率在糖尿病patients.RESEARCH设计和METHODS -调查，医疗记录，和行政数据从8,733名参与者中获得的转化为行动的糖尿病研究，多中心，前瞻性，观察性研究糖尿病护理管理。死亡（n = 79 - 1）和死亡原因的数据，从4年后的国家死亡指数。预测因素包括年龄、性别、种族、教育、收入、病程、糖尿病治疗、BMI、吸烟、微血管和大血管并发症以及合并症。（风险比[HR]1.04 [95% CI 1.03-1.051]），男性（1.57 [1.35-1.83]），低收入（75，000美元，HR 1.82 [1.30-2.541，15，000 - 40，000美元vs>$ 75，000，HR 1.58 [1.15-2.171），糖尿病持续时间较长（>= 9岁与< 9岁，HR 1.20 [1.02-1.41]），BMI较低（< 26 vs. 26-30 kg/m2，HR 1.43 [1.13-1.691]），吸烟（1.44 [1.20-1.74]），肾病（1.46 [1.232.73]）、大血管病变（1.46 [1.23-1.741）和较大的Charlson指数（>= 2-3 vs.< 1，HR 2.01 [1.04-3.90]; >= 3 vs. < 1，HR 4.38 [2.26-8.47]）。心血管和非心血管死亡率的预测因子不同。大血管疾病预测心血管疾病，但不是非心血管mortality.CONCLUSIONS -在糖尿病患者和获得医疗保健，年龄较大，男性，吸烟，肾脏疾病是死亡率的重要预测因素。即使在投保人群中，社会经济状况也是健康的重要独立预测因素。
OBJECTIVE - We sought to examine demographic, socioeconomic, and biological predictors of all-cause, cardiovascular, and noncardiovascular mortality in patients with diabetes.RESEARCH DESIGN AND METHODS - Survey, medical record, and administrative data were obtained from 8,733 participants in the Translating Research Into Action for Diabetes Study, a multicenter, prospective, observational study of diabetes care in managed care. Data on deaths (n = 79 1) and cause of death were obtained from the National Death Index after 4 years. Predictors examined included age, sex, race, education, income, duration, and treatment of diabetes, BMI, smoking, microvascular and macrovascular complications, and comorbidities.RESULTS - Predictors of adjusted all-cause mortality included older age (hazard ratio [HR]1.04 [95% CI 1.03-1.051), male sex (1.57 [1.35-1.83]), lower income ($75,000, HR 1.82 [1.30-2.541, $15,000-$40,000 vs.>$75,000, HR 1.58 [1.15-2.171), longer duration of diabetes ( >= 9 years vs. < 9 years, HR 1.20 [1.02-1.41]), lower BMI (< 26 vs. 26-30 k g/m(2), HR 1.43 [1.13-1.691), smoking (1.44 [1.20-1.74]), nephropathy (1.46 [1.232.73]), macrovascular disease (1.46 [1.23-1.741), and greater Charlson index ( >= 2-3 vs. < 1, HR 2.01 [1.04-3.90]; >= 3vs. < 1, HR 4.38 [2.26-8.47]). The predictors of cardiovascular and noncardiovascular mortality were different. Macrovascular disease predicted cardiovascular but not noncardiovascular mortality.CONCLUSIONS - Among people with diabetes and access to medical care, older age, male sex, smoking, and renal disease are important predictors of mortality. Even within an insured population, socioeconomic circumstance is an important independent predictor of health.