TY - JOUR
T1 - Subsequent mortality after hyperglycemic crisis episode in the non-elderly
T2 - a national population-based cohort study
AU - Kao, Yuan
AU - Hsu, Chien Chin
AU - Weng, Shih Feng
AU - Lin, Hung Jung
AU - Wang, Jhi Joung
AU - Su, Shih Bin
AU - Huang, Chien Cheng
AU - Guo, How Ran
N1 - Funding Information:
This study was supported by grants CMFHR10384 from the Chi-Mei Medical Center. This study is based in part on data from the Taiwan National Health Insurance Research Database provided by the National Health Insurance Administration, Ministry of Health and Welfare, and managed by National Health Research Institutes (Registered number NHIRD-100-057, NHIRD-102-024). The interpretation and conclusions contained herein do not represent those of the National Health Insurance Administration, Ministry of Health and Welfare or National Health Research Institutes. We thank Bill Franke for his invaluable advice and editorial assistance.
Funding Information:
This study was supported by grants CMFHR10384 from the Chi-Mei Medical Center. This study is based in part on data from the Taiwan National Health Insurance Research Database provided by the National Health Insurance Administration, Ministry of Health and Welfare, and managed by National Health Research Institutes (Registered number NHIRD-100-057, NHIRD-102-024). The interpretation and conclusions contained herein do not represent those of the National Health Insurance Administration, Ministry of Health and Welfare or National Health Research Institutes. We thank Bill Franke for his invaluable advice and editorial assistance.
Publisher Copyright:
© 2015, Springer Science+Business Media New York.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Hyperglycemic crisis episodes (HCEs)—diabetic ketoacidosis and the hyperosmolar hyperglycemic state—are the most serious acute metabolic complications of diabetes. We aimed to investigate the subsequent mortality after HCE in the non-elderly diabetic which is still unclear. This retrospective national population-based cohort study reviewed, in Taiwan’s National Health Insurance Research Database, data from 23,079 non-elder patients (≤65 years) with new-onset diabetes between 2000 and 2002: 7693 patients with HCE and 15,386 patients without HCE (1:2). Both groups were compared, and follow-up prognoses were done until 2011. One thousand eighty-five (14.1 %) patients with HCE and 725 (4.71 %) patients without HCE died (P < 0.0001) during follow-up. Incidence rate ratios (IRR) of mortality were 3.24 times higher in patients with HCE than in patients without HCE (P < 0.0001). Individual analysis of diabetic ketoacidosis and hyperosmolar hyperglycemic state also showed the similar result with combination of both. After stratification by age, mortality was significant higher in the middle age (40–64 years) [IRR 3.29; 95 % confidence interval (CI) 2.98–3.64] and young adult (18–39 years) (IRR 3.91; 95 % CI 3.28–4.66), but not in the pediatric subgroup (<18 years) (IRR 1.28; 95 % CI 0.21–7.64). The mortality risk was highest in the first month (IRR 54.43; 95 % CI 27.98–105.89), and still high after 8 years (IRR 2.05; 95 % CI 1.55–2.71). After adjusting for age, gender, and selected comorbidities, the mortality hazard ratio for patients with HCE was still four times higher than for patients without HCE. Moreover, older age, male gender, stroke, cancer, chronic obstructive pulmonary disease, congestive heart failure, and liver disease were independent mortality predictors. HCE significantly increases the subsequent mortality risk in the non-elderly with diabetes. Strategies for prevention and control of comorbidities are needed as soon as possible.
AB - Hyperglycemic crisis episodes (HCEs)—diabetic ketoacidosis and the hyperosmolar hyperglycemic state—are the most serious acute metabolic complications of diabetes. We aimed to investigate the subsequent mortality after HCE in the non-elderly diabetic which is still unclear. This retrospective national population-based cohort study reviewed, in Taiwan’s National Health Insurance Research Database, data from 23,079 non-elder patients (≤65 years) with new-onset diabetes between 2000 and 2002: 7693 patients with HCE and 15,386 patients without HCE (1:2). Both groups were compared, and follow-up prognoses were done until 2011. One thousand eighty-five (14.1 %) patients with HCE and 725 (4.71 %) patients without HCE died (P < 0.0001) during follow-up. Incidence rate ratios (IRR) of mortality were 3.24 times higher in patients with HCE than in patients without HCE (P < 0.0001). Individual analysis of diabetic ketoacidosis and hyperosmolar hyperglycemic state also showed the similar result with combination of both. After stratification by age, mortality was significant higher in the middle age (40–64 years) [IRR 3.29; 95 % confidence interval (CI) 2.98–3.64] and young adult (18–39 years) (IRR 3.91; 95 % CI 3.28–4.66), but not in the pediatric subgroup (<18 years) (IRR 1.28; 95 % CI 0.21–7.64). The mortality risk was highest in the first month (IRR 54.43; 95 % CI 27.98–105.89), and still high after 8 years (IRR 2.05; 95 % CI 1.55–2.71). After adjusting for age, gender, and selected comorbidities, the mortality hazard ratio for patients with HCE was still four times higher than for patients without HCE. Moreover, older age, male gender, stroke, cancer, chronic obstructive pulmonary disease, congestive heart failure, and liver disease were independent mortality predictors. HCE significantly increases the subsequent mortality risk in the non-elderly with diabetes. Strategies for prevention and control of comorbidities are needed as soon as possible.
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U2 - 10.1007/s12020-015-0669-8
DO - 10.1007/s12020-015-0669-8
M3 - Article
C2 - 26115971
AN - SCOPUS:84953839611
SN - 1355-008X
VL - 51
SP - 72
EP - 82
JO - Endocrine
JF - Endocrine
IS - 1
ER -
