Short-Term Case Fatality Rate and Associated Factors among Inpatients with Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State: A Hospital-Based Analysis over a 15-Year Period
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概要
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Background and Purpose Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are usually life threatening, but the recent trend of 28-day case-fatality and associated risk factors including Charlson index have not been known. Our aim was to evaluate the 28-day case-fatality rate among hospitalized DKA and HHS patients in a teaching hospital in Taiwan from 1991 to 2005. Methods DKA and HHS admissions, identified from in-patient electronic database, were linked to Taiwans national death registry. Kaplan-Meier analysis was used to determine the 28-day case-fatality rates of DKA and HHS, and to compare the trend of case-fatality over three consecutive 5-year periods (i.e, 1991-1995, 1996-2000, 2001-2005). We also used the Cox proportional hazard regression model to explore the determinants of 28-day case-fatality of the study patients. Results The 28-day case-fatality rates for DKA and HHS were 6.10% and 18.83%, and the lowest ones were observed in 2001-2005 (2.65% and 11.63% in DKA and HHS, respectively). Pneumonia was a significant predictor for increased 28-day case-fatality in both illnesses. Additionally, older age and stroke were significantly associated with increased case-fatality in DKA patients while myocardial infarction and higher Charlson index were significant predictors for higher case-fatality in HHS patients. Conclusion Improvements in case-fatality in recent years for both DKA and HHS were found in the study hospital. Further reduction of the case-fatality rate among DKA and HHS patients can be achieved by optimal management of certain co-morbidities.
著者
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Li Chung-yi
Department Of Health Care Management National Taipei College Of Nursing
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Chen Hua-Fen
Department of Endocrinology, Far-Eastern Memorial Hospital
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Wang Chih-Yuan
Department of Endocrinology, Far-Eastern Memorial Hospital
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Lee Hsin-Yu
Department of Endocrinology, Far-Eastern Memorial Hospital
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See Ting-Ting
Department of Endocrinology, Far-Eastern Memorial Hospital
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Chen Mei-Hsiu
Department of Endocrinology, Far-Eastern Memorial Hospital
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Jiang Ju-Ying
Department of Endocrinology, Far-Eastern Memorial Hospital
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Lee Ming-Tsang
Department of Endocrinology, Far-Eastern Memorial Hospital
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Lee Hsin-yu
Department Of Aquaculture National Taiwan Ocean University
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Li Chung-yi
Department And Graduate Institute Of Public Health College Of Medicine National Cheng Kung University
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Chen Hua-fen
Department Of Endocrinology Far Eastern Memorial Hospital
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- Short-Term Case Fatality Rate and Associated Factors among Inpatients with Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State: A Hospital-Based Analysis over a 15-Year Period
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