Risk of Mortality and Hospitalization After Post-Pancreatitis Diabetes Mellitus vs Type 2 Diabetes Mellitus: A Population-Based Matched Cohort Study
Risk of Mortality and Hospitalization After Post-Pancreatitis Diabetes Mellitus vs Type 2 Diabetes Mellitus: A Population-Based Matched Cohort Study
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DOI：
10.14309/ajg.0000000000000225
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发表时间：
2019-05-01
影响因子：
9.8
通讯作者：
Petrov, Maxim S.
中科院分区：
文献类型：
--
作者：
Cho, Jaelim;Scragg, Robert;Petrov, Maxim S.
目的：与2型糖尿病(T2 DM)患者比较，探讨胰腺炎后糖尿病(PPDM)患者的死亡率和住院风险。方法：利用新西兰全国范围内的胰腺炎和糖尿病出院数据(n=231,943)，共确定959名PPDM患者。随机选择10例年龄和性别匹配的T2 DM患者作为研究对象。结果：10,549名受试者中共有3,867人死亡。产后糖尿病患者的全因死亡率为80.5(95%CI，70.3-90.6)/1000人年，高于T2 DM患者(调整后的HR为1.13(95%CI，1.00-1.29)；绝对超额风险为14.8(95%CI，4.5-25.2)/1000人年)。与T2 DM相比，PDM患者死于癌症(调整后HR，1.44；95%CI，1.13-1.83)、感染(调整后HR，2.52；95%CI，1.69-3.77)和胃肠道疾病(调整后HR，2.56；95%CI，1.64-4.01)的风险更高。与T2 DM患者相比，PPDM患者因慢性肺部疾病、中重度肾脏疾病和感染性疾病而住院的风险也显著增加。结论：与T2 DM患者相比，PPDM患者的死亡率和住院风险更高。需要制定PPDM管理指南，以期防止PPDM患者的过度死亡和住院。
Objectives:To investigate the risk of mortality and hospitalization in individuals with post-pancreatitis diabetes mellitus (PPDM) compared with those with type 2 diabetes mellitus (T2DM).Methods:Using nationwide hospital discharge data on pancreatitis and diabetes in New Zealand (n = 231,943), a total of 959 individuals with PPDM were identified. For each individual with PPDM, 10 age- and sex-matched individuals with T2DM were randomly selected. Multivariable Cox regression analysis was conducted, and the risk was expressed as hazard ratio (HR) and 95% confidence interval (CI).Results:A total of 3,867 deaths occurred among 10,549 study individuals. Individuals with PPDM had all-cause mortality rate at 80.5 (95% CI, 70.3-90.6) per 1,000 person-years, which was higher compared with T2DM individuals (adjusted HR, 1.13 (95% CI, 1.00-1.29); absolute excess risk, 14.8 (95% CI, 4.5-25.2) per 1,000 person-years). Compared with T2DM, PPDM was associated with higher risks of mortality from cancer (adjusted HR, 1.44; 95% CI, 1.13-1.83), infectious disease (adjusted HR, 2.52; 95% CI, 1.69-3.77), and gastrointestinal disease (adjusted HR, 2.56; 95% CI, 1.64-4.01). Individuals with PPDM vs T2DM were also at significantly higher risks of hospitalization for chronic pulmonary disease, moderate to severe renal disease, and infectious disease.Conclusions:Individuals with PPDM have higher risk of mortality and hospitalization compared with individuals with T2DM. Guidelines for management of PPDM need to be developed with a view to preventing excess deaths and hospitalizations in individuals with PPDM.