Subsequent mortality after hyperglycemic crisis episode in the non-elderly: a national population-based cohort study

Yuan Kao, Chien Chin Hsu, Shih Feng Weng, Hung Jung Lin, Jhi Joung Wang, Shih Bin Su, Chien Cheng Huang, How Ran Guo

研究成果: Article同行評審

14 引文 斯高帕斯(Scopus)

摘要

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.

原文English
頁(從 - 到)72-82
頁數11
期刊Endocrine
51
發行號1
DOIs
出版狀態Published - 2016 一月 1

All Science Journal Classification (ASJC) codes

  • 內分泌學、糖尿病和代謝
  • 內分泌

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