Predictors of mortality in hospitalized diabetic patients: A 7-year prospective study

Wu, Maochun; Lee, Wen‐Jane; Tschen, Scheng-Ming; Lin, Sheng-Di; Lee, I-Te; Jeng, Chii; Tseng, Li-Nien; Liu, Yingmei; Chen, Been-Yuan; Sheu, Wayne H‐H

doi:10.1016/j.diabres.2007.11.020

Cited by 11 publications

(3 citation statements)

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“…Furthermore, the mortality rate of hospitalized diabetic patients was 2.98-fold higher than that of Taiwan’s general population [30]. Although the mortality rate of diabetic patients has decreased in recent decades [31], there was still a high cumulative mortality rate (53.7%) in type 2 diabetic inpatients admitted due to poor blood glucose control in the present study.…”

Section: Discussionmentioning

confidence: 58%

Inpatient screening for albuminuria and retinopathy to predict long-term mortality in type 2 diabetic patients: a retrospective cohort study

Hsieh

Lee

Sheu

et al. 2017

Diabetol Metab Syndr

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BackgroundThere is a high hospitalization rate for diabetic patients. Since retinopathy and albuminuria are both important manifestations of microvascular disease in diabetes, our aim was to investigate the effect of retinopathy and albuminuria on long-term mortality in type 2 diabetic inpatients through this observational cohort study.MethodsType 2 diabetic inpatients given a primary diagnosis of poor glucose control were consecutively enrolled during their hospitalization periods. Clinical information was collected through review of each patient’s medical records, and mortality data were obtained from the national registry in Taiwan.ResultsA total of 761 type 2 diabetic inpatients were enrolled in the study with a median follow-up period of 6.6 years (interquartile range, 4.0–9.6 years). Patients in the Albuminuria(−)/Retinopathy(+), Albuminuria(+)/Retinopathy(−) and Albuminuria(+)/Retinopathy(+) groups had significantly higher risks of all-cause mortality and cardiovascular mortality than those in the Albuminuria(−)/Retinopathy(−) group. However, among patients with albuminuria, there was no significant difference in cumulative mortality between those with and without retinopathy (P = 0.821). A decrease in the estimated glomerular filtration rate (eGFR), but not retinopathy, was an independent predictor of all-cause mortality (95% CI 0.647‒0.893; P < 0.001) and cardiovascular mortality (95% CI 0.564‒0.921; P = 0.009) in type 2 diabetic inpatients with albuminuria.ConclusionsAlbuminuria in type 2 diabetic inpatients is a strong predictor of long-term mortality after discharge from the hospital. Retinopathy is an independent predictor of mortality in type 2 diabetic inpatients without albuminuria but not in those with albuminuria. A low eGFR is a better predictor of mortality than retinopathy in type 2 diabetic inpatients with albuminuria.

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Section: Discussionmentioning

confidence: 58%

Inpatient screening for albuminuria and retinopathy to predict long-term mortality in type 2 diabetic patients: a retrospective cohort study

Hsieh

Lee

Sheu

et al. 2017

Diabetol Metab Syndr

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“…Мы не обнаружили независимой связи 5-летней общей смертности с параметрами, которые влияли на нее в исследованиях других авторов, в первую очередь с различными атеросклеротическими СС-заболеваниями и дислипидемией, рСКФ/другими показателями почечной функции/ХБП, социально-экономическим статусом пациентов, в частности низким или средним уровнем доходов и низким уровнем образования [17,19,[34][35][36][37]. Это может объясняться в первую очередь меньшим размером нашей когорты в сравнении с количеством пациентов в указанных многоцентровых исследованиях.…”

Section: Discussionunclassified

“…Возвращаясь к возможным предикторам общей смертности больных СД2, подчеркнем, что даже среди самых крупных проспективных исследований [14,15] нам не удалось найти таких, где в одной выборке одновременно рассматривалось бы независимое влияние на смертность совокупности биологических (клинико-лабораторных), демографических, социально-экономических и психологических факторов, включая депрессию и когнитивную дисфункцию. Кроме того, влияние психических расстройств на смертность как в популяции в целом, так и при СД может существенно зависеть от географических и этнических различий, разных принципов организации медицинской помощи, качества лечения различных факторов риска и психических расстройств в той или иной стране [16][17][18][19]. В Российской Федерации проспективные исследования прогностического влияния депрессии и когнитивных нарушений на общую смертность больных СД2, тем более в сопоставлении с влиянием максимального количества других биологических и иных факторов, не проводились, что делает актуальным изучение этого вопроса.…”

Section: обоснованиеunclassified

Depression, cognitive dysfunction and other factors associated with 5-year overall mortality in type 2 diabetes mellitus: a pilot prospective observational study

2022

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BACKGROUND: Psychological predictors of overall mortality in the Russian population of Type 2 diabetic patients and their impact compared to biological risk factors have not been studied.AIM. To identify clinical, laboratory and psychological factors independently associated with the 5-year overall mortality in Type 2 diabetic patients in the Moscow region.MATERIALS AND METHODS: This open label observational prospective study included 178 consecutive type 2 diabetic patients (women 145, men 33, age range 37 to 82 years, duration of diabetes 0,5 to 30 years). At baseline, in addition to the standard clinical, laboratory and instrumental work-up, all patients were assessed for depression, cognitive dysfunction and diabetes-related quality of life. No study-related intervention was performed; all patients were followed up and treated by their local physicians. After 5 years, we assessed the patients’ vital status (alive or dead). Multiple logistic regression was used to identify baseline patients’ characteristics, which were significantly and independently associated with 5-year overall mortality. Taking into account the exploratory type of multiple regression, the results were considered significant at α<0.1.RESULTS: At 5 years, 150 (84%) patients were alive and 15 (8,4%) were dead; no information could be obtained for the rest 13 (7,3%) patients. The analysis of 165 patients with the verified outcome, independent and significant associations with the death outcome were found for male gender (odds ratio [OR] 6,36 [95%CI 0,91–44.40]; p=0.06), age (OR 2.06 [1.30–3.27]; p<0.002), chronic heart failure (CHF) (OR 2.78 [1.25–6.2]; р=0.012), Hamilton depression scale score (OR 1,18 [1.03–1.34]; р=0.016), cognitive dysfunction score (Roschina scale) (OR 1.20 [1.05–1.35]; р=0.006), and age — body mass index interaction (OR 0,98 [0,97–0,997]; р = 0,013). The predicted probability of death within the next 5 years in men and women was 22,9% and 6,7%, respectively. The highest score of cognitive dysfunction was associated with a 25% predicted probability of death and the lowest, with a 2% probability of death; predicted probabilities of death for the highest and lowest depression scores were 26% and 2%, respectively. The 5-year predicted probability of death in the patients without CHF was 6,7%, with CHF I NYHA functional class, 9,8%, II functional class 13,6%, III functional class 18,2%, and IV functional class 23,5%. All other baseline clinical, laboratory, demographic, psychological and socioeconomic variables were not significantly associated with the 5-year survival rate. The model was not verified on an external cohort.CONCLUSION: Cognitive dysfunction and depression have a significant negative impact on the 5-year mortality rate at much higher degree, than glycemic control, any diabetes-related complications and cardiovascular disorders, excluding CHF. The results obtained highlight the importance of the diagnosis and treatment of depression and cognitive dysfunction in type 2 diabetes mellitus.

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Current literature in diabetes

2009

Diabetes Metabolism Res

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of diabetes/metabolism. Each bibliography is divided into 26 sections: 1 Reviews; 2 General; 3 Genetics; 4 Epidemiology; 5 Immunology; 6 Obesity; 7 Prediction and Prevention; 8 Intervention: a) General; b) Care; c) Drug Therapy; d)Economics; e) Gene therapy; f) Nursing; g) Nutrition; h) Surgery; i) Transplantation; 9 Pathology and Complications: a) General; b) Cardiovascular; c) Eye disease; d) Gestational and fetal; e) Neurological; f) Podiatrical; g) Renal; 10 Endocrinology & Metabolism; 11 Experimental Studies; 12 Diagnosis and Techniques. Within each section, articles are listed in alphabetical order with respect to author

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Predictors of mortality in hospitalized diabetic patients: A 7-year prospective study

Cited by 11 publications

References 22 publications

Inpatient screening for albuminuria and retinopathy to predict long-term mortality in type 2 diabetic patients: a retrospective cohort study

Inpatient screening for albuminuria and retinopathy to predict long-term mortality in type 2 diabetic patients: a retrospective cohort study

Depression, cognitive dysfunction and other factors associated with 5-year overall mortality in type 2 diabetes mellitus: a pilot prospective observational study

Current literature in diabetes

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