Long-term mortality in outpatients with type 2 diabetes in a reference hospital in Cameroon: a retrospective cohort study
| Autor: | Noel Désiré Mbango, Vanessa Balla, Yannick Mboue-Djieka, Chobufo Ditah, Joyce Bei Foryoung, Peter Nde Fon, Daniel Nebongo, Simeon-Pierre Choukem |
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| Rok vydání: | 2018 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty Population 030209 endocrinology & metabolism predictor Type 2 diabetes 030204 cardiovascular system & hematology survival 03 medical and health sciences cause of death 0302 clinical medicine Metabolic Diseases Risk Factors Internal medicine Outpatients medicine Humans Cameroon education Referral and Consultation Cause of death Aged Retrospective Studies Response rate (survey) Glycated Hemoglobin education.field_of_study Proteinuria business.industry Mortality rate Research Retrospective cohort study General Medicine Middle Aged medicine.disease Diabetic foot Survival Analysis mortality Diabetes and Endocrinology Diabetes Mellitus Type 2 Multivariate Analysis Female type 2 diabetes medicine.symptom business |
| Zdroj: | BMJ Open |
| ISSN: | 2044-6055 |
| Popis: | ObjectivesThere are limited data on mortality in patients with type 2 diabetes mellitus (T2DM) in Sub-Saharan Africa. We aimed at determining the mortality rate, and the causes and the predictors of death in patients with T2DM followed as outpatients in a reference hospital in Cameroon.DesignRetrospective cohort study.SettingA reference hospital in Cameroon.ParticipantsFrom December 2015 to March 2016, patients with T2DM aged 18 years and older and who consulted between January 2009 and December 2014, were contacted directly or through their next of kin, and included in this study. All participants with less than 75% of desired data in files, those who could not be reached on the phone and those who refused to provide consent were excluded from the study. Of the 940 eligible patients, 628 (352 men and 276 women) were included and completed the study, giving a response rate of 66.8%.Outcome measuresDeath rate, causes of death and predictors of death.ResultsOf the 628 patients (mean age: 56.5 years; median diabetes duration: 3.5 years) followed up for a total of 2161 person-years, 54 died, giving a mortality rate of 2.5 per 100 person-years and a cumulative mortality rate of 8.6%. Acute metabolic complications (22.2%), cardiovascular diseases (16.7%), cancers (14.8%), nephropathy (14.8%) and diabetic foot syndrome (13.0%) were the most common causes of death. Advanced age (adjusted HR (aHR) 1.06, 95% CI 1.02 to 1.10; P=0.002), raised glycated haemoglobin (HbA1c) (aHR 1.16, 95% CI 1.00 to 1.35; P=0.051), low blood haemoglobin (aHR 1.06, 95% CI 1.02 to 1.10; P=0.002) and proteinuria (aHR 2.97, 95% CI 1.40 to 6.28; P=0.004) were identified as independent predictors of death.ConclusionsThe mortality rate in patients with T2DM is high in our population, with acute metabolic complications as the leading cause. Patients with advanced age, raised HbA1c, anaemia or proteinuria are at higher risk of death and therefore represent the target of interest to prevent mortality in T2DM. |
| Databáze: | OpenAIRE |
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