Background and aims
The ongoing COVID-19 pandemic is disproportionately affecting patients with comorbidities. Therefore, thorough comorbidities assessment can help establish risk stratification of patients with COVID-19, upon hospital admission. Charlson Comorbidity Index (CCI) is a validated, simple, and readily applicable method of estimating the risk of death from comorbid disease and has been widely used as a predictor of long-term prognosis and survival.
Methods
We performed a systematic review and meta-analysis of CCI score and a composite of poor outcomes through several databases.
Results
Compared to a CCI score of 0, a CCI score of 1–2 and CCI score of ≥3 was prognostically associated with mortality and associated with a composite of poor outcomes. Per point increase of CCI score also increased mortality risk by 16%. Moreover, a higher mean CCI score also significantly associated with mortality and disease severity.
Conclusion
CCI score should be utilized for risk stratifications of hospitalized COVID-19 patients.
Tujuan: Mengumpulkan informasi mengenai penanganan dan komplikasi diabetes, serta kesadaran pengendalian diri sendiri penderita diabetes di Indonesia. Studi ini juga mengevaluasi perspektif dokter, aspek psikologis, dan kualitas hidup pasien. Metode: Studi non-intervensi, potong lintang, merekrut 1832 pasien dari pusat kesehatan sekunder dan tersier di Indonesia. Data mengenai demografi , riwayat medis, faktor resiko, dan laporan pemeriksaan klinis termasuk laboratorium dikumpulkan dari rekam medis pasien. Sampel darah dikumpulkan untuk pengukuran HbA1c yang tersentralisasi.
Background:The First Basal Insulin Evaluation (FINE) Asia study is a multinational, prospective, observational study of insulin-naïve Type 2 diabetes mellitus (T2DM) patients in Asia, uncontrolled (A1c ≥ 8%) on oral hypoglycemic agents, designed to evaluate the impact of basal insulin initiation.Methods:Basal insulin was initiated with or without concomitant oral therapy and doses were adjusted individually. All treatment choices, including the decision to initiate insulin, were at the physician's discretion to reflect real-life practice.Results:Patients (n= 2679) from 11 Asian countries were enrolled (mean [±SD] duration of diabetes 9.3 ± 6.5 years; weight 68.1 ± 12.7 kg; A1c 9.8 ± 1.6%). After 6 months of basal insulin (NPH insulin, insulin glargine, or insulin detemir), A1c decreased to 7.7 ± 1.4%; 33.7% patients reached A1c <7%. Fasting blood glucose (FBG) decreased from 11.7 ± 3.6 to 7.2 ± 2.5 mmol/L and 36.8% of patients reached FBG <6.1 mmol/L. The mean daily insulin dose prescribed increased marginally from 0.18 to 0.23 U/kg per day at baseline to 0.22–0.24 U/kg per day at Month 6. Mean changes in body weight and reported rates of hypoglycemia were low over the duration of the study.Conclusions:Initiation of insulin therapy is still being delayed by approximately 9 years, resulting in many Asian patients developing severe hyperglycemia. Initiating insulin treatment with basal insulin was effective and safe in Asian T2DM patients in a real-world setting, but insulin needs may differ from those in Western countries.
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