芬兰糖尿病酮症酸中毒患者的临床特点及预后分析

IF 1 Q4 ENDOCRINOLOGY & METABOLISM Diabetes epidemiology and management Pub Date : 2023-04-01 DOI:10.1016/j.deman.2023.100129

Elena Putula , Heini Huhtala , Sini Vanhamäki , Tiina Laatikainen , Aapo Tahkola , Päivi Hannula , Saara Metso

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引用次数: 0

摘要

目的通过回顾性病例对照研究，探讨坦佩雷大学医院糖尿病酮症酸中毒(DKA)患者的预后及危险因素。方法纳入2014-2020年期间在Tays接受DKA治疗的282例患者(年龄≥15岁)。从芬兰国家糖尿病登记处收集了846名对照者，根据年龄、性别、糖尿病类型和所在城市进行了调整，随访期间没有任何DKA。从芬兰国家糖尿病登记处获得的HbA1c、精神和行为障碍以及死亡率在有和没有DKA的患者之间进行了比较。结果患者年龄中位数为36岁。10%的DKA患者在平均3年的随访期间死亡。DKA患者的死亡率是对照组的6倍(OR 6.28;95% ci 3.17-12.42)。DKA患者有较高的药物滥用率(OR 4.68;95% CI 3.23-6.78)和抑郁(OR 2.24;95% CI 1.58-3.18)， HbA1c水平中位数较高(84比61 mmol/mol, p <0.001)。19%的DKA患者(53例)有复发性DKA。结论sdka是早期死亡的有力指标。血糖控制不良、抑郁和药物滥用是DKA的危险因素。

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Clinical characteristics and prognoses of patients with diabetic ketoacidosis in Finland

Aims

To assess the prognosis and risk factors for diabetic ketoacidosis (DKA) in Tampere University Hospital (Tays) in a retrospective case-control study.

Methods

All 282 patients (age ≥15 years) treated for DKA in Tays during the period 2014–2020 were included. A total of 846 controls adjusted for age, gender, diabetes type and municipality, and without any DKA during follow-up were collected from the Finnish National Diabetes Registry. HbA1c, mental and behavioural disorders, and mortality obtained from the Finnish National Diabetes Registry were compared between patients with and without DKA.

Results

Patients’ median age was 36 years. Ten percent of the patients with DKA died during the median follow-up time of three years. Mortality rate was sixfold higher in patients with DKA than among the controls (OR 6.28; 95% CI 3.17–12.42). Patients with DKA had higher rates of substance abuse (OR 4.68; 95% CI 3.23–6.78) and depression (OR 2.24; 95% CI 1.58–3.18), and higher median HbA1c levels (84 vs. 61 mmol/mol, p < 0.001). Nineteen percent of the DKA patients (n = 53) had recurrent DKA.