Abstract：
UNASSIGNED: Fluid overload is a known complication in patients with diabetes mellitus, particularly those with cardiovascular and/or chronic kidney disease (CKD). This study investigates the impact of fluid overload on healthcare utilisation and its association with diabetes-related complications.
UNASSIGNED: Electronic medical records from the SingHealth Diabetes Registry (2013-2022) were analysed. Hospitalisations due to fluid overload were identified using International Classification of Diseases, 10th Revision (ICD-10) discharge codes. Trends were examined using Joinpoint regression, and associations were assessed with generalised estimating equation models.
UNASSIGNED: Over a period of 10 years, 259,607 individuals treated at primary care clinics and tertiary hospitals were studied. The incidence of fluid overload-related hospitalisations decreased from 2.99% (n=2778) in 2013 to 2.18% (n=2617) in 2017. However, this incidence increased from 2.42% (n=3091) in 2018 to 3.71% (n=5103) in 2022. The strongest associations for fluid overload-related hospitalisation were found with CKD stages G5 (odds ratio [OR] 6.61, 95% confidence interval [CI] 6.26-6.99), G4 (OR 5.55, 95% CI 5.26-5.86) and G3b (OR 3.18, 95% CI 3.02-3.35), as well as with ischaemic heart disease (OR 3.97, 95% CI 3.84-4.11), acute myocardial infarction (OR 3.07, 95% CI 2.97-3.18) and hypertension (OR 3.90, 95% CI 3.45-4.41). Additionally, the prevalence of stage G5 CKD among patients with fluid overload increased between 2018 and 2022.
UNASSIGNED: Our study revealed a significant increase in fluid overload-related hospitalisations and extended lengths of stay, likely driven by severe CKD. This underscores an urgent need for initiatives aimed at slowing CKD progression and reducing fluid overload-related hospitalisations in diabetes patients.
UNASSIGNED: Electronic medical records from the SingHealth Diabetes Registry (2013-2022) were analysed. Hospitalisations due to fluid overload were identified using International Classification of Diseases, 10th Revision (ICD-10) discharge codes. Trends were examined using Joinpoint regression, and associations were assessed with generalised estimating equation models.
UNASSIGNED: Over a period of 10 years, 259,607 individuals treated at primary care clinics and tertiary hospitals were studied. The incidence of fluid overload-related hospitalisations decreased from 2.99% (n=2778) in 2013 to 2.18% (n=2617) in 2017. However, this incidence increased from 2.42% (n=3091) in 2018 to 3.71% (n=5103) in 2022. The strongest associations for fluid overload-related hospitalisation were found with CKD stages G5 (odds ratio [OR] 6.61, 95% confidence interval [CI] 6.26-6.99), G4 (OR 5.55, 95% CI 5.26-5.86) and G3b (OR 3.18, 95% CI 3.02-3.35), as well as with ischaemic heart disease (OR 3.97, 95% CI 3.84-4.11), acute myocardial infarction (OR 3.07, 95% CI 2.97-3.18) and hypertension (OR 3.90, 95% CI 3.45-4.41). Additionally, the prevalence of stage G5 CKD among patients with fluid overload increased between 2018 and 2022.
UNASSIGNED: Our study revealed a significant increase in fluid overload-related hospitalisations and extended lengths of stay, likely driven by severe CKD. This underscores an urgent need for initiatives aimed at slowing CKD progression and reducing fluid overload-related hospitalisations in diabetes patients.
摘要：
■液体超负荷是糖尿病患者的已知并发症，特别是那些患有心血管和/或慢性肾脏疾病（CKD）。这项研究调查了液体超负荷对医疗保健利用的影响及其与糖尿病相关并发症的关系。
■分析了SingHealth糖尿病登记处（2013-2022）的电子病历。使用国际疾病分类确定了由于液体超负荷导致的住院治疗，第十次修订(ICD-10)放电代码。使用Joinpoint回归检查趋势，并利用广义估计方程模型对关联进行了评估。
■在10年的时间里，研究了259,607名在初级保健诊所和三级医院接受治疗的人。与液体超负荷相关的住院发生率从2013年的2.99％（n=2778）下降到2017年的2.18％（n=2617）。然而,这一发病率从2018年的2.42%(n=3091)上升至2022年的3.71%(n=5103).发现与液体超负荷相关的住院与CKD分期G5相关（比值比[OR]6.61，95％置信区间[CI]6.26-6.99），G4（OR5.55，95%CI5.26-5.86）和G3b（OR3.18，95%CI3.02-3.35），以及缺血性心脏病(OR3.97，95%CI3.84-4.11)，急性心肌梗死(OR3.07,95%CI2.97-3.18)和高血压(OR3.90,95%CI3.45-4.41)。此外,2018年至2022年期间,G5期CKD在液体超负荷患者中的患病率增加.
■我们的研究表明，与液体超负荷相关的住院时间和住院时间显着增加，可能由严重CKD驱动。这强调了迫切需要采取旨在减缓CKD进展和减少糖尿病患者与液体超负荷相关的住院治疗的举措。
■分析了SingHealth糖尿病登记处（2013-2022）的电子病历。使用国际疾病分类确定了由于液体超负荷导致的住院治疗，第十次修订(ICD-10)放电代码。使用Joinpoint回归检查趋势，并利用广义估计方程模型对关联进行了评估。
■在10年的时间里，研究了259,607名在初级保健诊所和三级医院接受治疗的人。与液体超负荷相关的住院发生率从2013年的2.99％（n=2778）下降到2017年的2.18％（n=2617）。然而,这一发病率从2018年的2.42%(n=3091)上升至2022年的3.71%(n=5103).发现与液体超负荷相关的住院与CKD分期G5相关（比值比[OR]6.61，95％置信区间[CI]6.26-6.99），G4（OR5.55，95%CI5.26-5.86）和G3b（OR3.18，95%CI3.02-3.35），以及缺血性心脏病(OR3.97，95%CI3.84-4.11)，急性心肌梗死(OR3.07,95%CI2.97-3.18)和高血压(OR3.90,95%CI3.45-4.41)。此外,2018年至2022年期间,G5期CKD在液体超负荷患者中的患病率增加.
■我们的研究表明，与液体超负荷相关的住院时间和住院时间显着增加，可能由严重CKD驱动。这强调了迫切需要采取旨在减缓CKD进展和减少糖尿病患者与液体超负荷相关的住院治疗的举措。
