Markedly increased incidence of critical illness in adults with Type 1 diabetes
| Autor: | Allan Garland, Hui Chen, Ruth Ann Marrie, Christine A. Peschken, Randy Fransoo, Elizabeth A. C. Sellers, Carol A. Hitchon, Charles N. Bernstein |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Canada Adolescent Endocrinology Diabetes and Metabolism Critical Illness Population Myocardial Ischemia 030209 endocrinology & metabolism Rate ratio Infections law.invention Diabetic Ketoacidosis Diabetes Complications 03 medical and health sciences Young Adult 0302 clinical medicine Endocrinology Patient Admission law Internal Medicine medicine Humans 030212 general & internal medicine education Child education.field_of_study Type 1 diabetes business.industry Mortality rate Incidence (epidemiology) Incidence Hazard ratio medicine.disease Intensive care unit 3. Good health Intensive Care Units Diabetes Mellitus Type 1 Case-Control Studies Child Preschool Cohort Female business |
| Zdroj: | Diabetic medicine : a journal of the British Diabetic Association. 34(10) |
| ISSN: | 1464-5491 |
| Popis: | Aims To compare the incidence of and mortality after intensive care unit admission in adults with paediatric-onset Type 1 diabetes vs the general population. Methods Using population-based administrative data from Manitoba, Canada, we identified 814 cases of paediatric-onset Type 1 diabetes, and 3579 general population controls matched on age, sex and region of residence. We estimated the incidence of intensive care unit admission in adulthood, and compared the findings between populations using incidence rate ratios and multivariable Cox proportional hazards regression, adjusting for age, sex, comorbidity and socio-economic status. We estimated age- and sex-standardized mortality rates after intensive care unit admission. Results Between January 2000 and October 2009, the average annual incidence of intensive care unit admission among prevalent cohorts was 910 per 100 000 in the Type 1 diabetes population, and 106 per 100 000 in matched controls, an eightfold increased risk (incidence rate ratio 8.6; 95% CI 5.5, 14.0). The adjusted risk of intensive care unit admission was elevated to a greater extent among women with Type 1 diabetes compared with matched women (hazard ratio 14.7; 95% CI 7.2, 29.4) than among m en with Type 1 diabetes compared with matched men (hazard ratio 4.92; 95% CI 10.3, 2.36) The most common reasons for admission in the diabetes cohort were diabetic ketoacidosis, infection and ischaemic heart disease. At 30%, 5-year mortality was higher in the diabetes cohort than in the matched cohort (relative risk 5.7; 95% CI 1.2, 8.9). Conclusions Compared with the general population, the risk of intensive care unit admission was higher in adults with paediatric-onset Type 1 diabetes, and mortality after admission was also higher. This article is protected by copyright. All rights reserved. |
| Databáze: | OpenAIRE |
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