背景:本研究旨在评估心脑血管疾病(CCD)对住院1型糖尿病(T1DM)患者的负担和影响。
方法:这是2016年至2019年美国国家住院患者样本中T1DM伴或不伴CCD患者的回顾性全国队列研究。住院死亡率,停留时间(LoS),并确定了医疗费用。
结果:总共59,860例T1DM患者有CCD的初步诊断,1,382,934例没有。与无CCD患者相比,有CCD患者的中位数LoS更长(4.6vs.3天)。与没有CCD的患者相比,T1DM和CCD患者的住院死亡率更高(4.1%vs.1.1%,p<0.001)。所有T1DM合并CCD患者的估计总护理费用约为3.26亿美元。与非CCD入院患者相比,颅内出血的调整后死亡率最高(OR17.37,95CI12.68-23.79),肺栓塞(OR4.39,95CI2.70-7.13),心内膜炎(OR3.46,95CI1.22-9.84),急性心肌梗死(OR2.31,95CI1.92-2.77),和中风(OR1.47,95CI1.04-2.09)。
结论:T1DM患者的CCD负担是巨大的,并且与医院死亡率和高医疗支出显著相关。
BACKGROUND: This study aimed to evaluate the burden and impact of cardiac and cerebrovascular disease (CCD) on hospital inpatients with type 1 diabetes mellitus (T1DM).
METHODS: This is a retrospective nationwide cohort study of people with T1DM with or without CCD in the US National Inpatient Sample between 2016 and 2019. The in-hospital mortality rates, length of stay (LoS), and healthcare costs were determined.
RESULTS: A total of 59,860 T1DM patients had a primary diagnosis of CCD and 1,382,934 did not. The median LoS was longer for patients with CCD compared to no CCD (4.6 vs. 3 days). Patients with T1DM and CCD had greater in-hospital mortality compared to those without CCD (4.1% vs. 1.1%, p < 0.001). The estimated total care cost for all patients with T1DM with CCD was approximately USD 326 million. The adjusted odds of mortality compared to patients with non-CCD admission was greatest for intracranial hemorrhage (OR 17.37, 95%CI 12.68-23.79), pulmonary embolism (OR 4.39, 95%CI 2.70-7.13), endocarditis (OR 3.46, 95%CI 1.22-9.84), acute myocardial infarction (OR 2.31, 95%CI 1.92-2.77), and stroke (OR 1.47, 95%CI 1.04-2.09).
CONCLUSIONS: The burden of CCD in patients with T1DM is substantial and significantly associated with increased hospital mortality and high healthcare expenditures.