糖尿病与哮喘住院患者的结局恶化相关
2020/11/17
摘要
背景：哮喘是一种具有高经济成本的流行疾病。直接费用的50％以上与哮喘住院有关。糖尿病（DM）在哮喘患者中是一种重要的合并症，但对哮喘相关住院的影响尚不清楚。
目的：比较有无糖尿病的哮喘患者住院治疗的结局。
方法：我们使用“医疗保健费用和利用项目”全国再入院数据库，分析了所有有哮喘但无其他慢性肺病的成年住院患者的数据，并比较了患有和不患有DM的患者的结局。加权回归分析用于确定糖尿病对住院结局的影响。所有多元回归模型都针对患者的人口统计学，社会经济状况和慢性合并症进行了调整。
结果：研究总共纳入717,200名哮喘患者，其中202,489名（28.3％）患有DM。糖尿病患者年龄较大，合并症更多。当因哮喘住院时，糖尿病患者的住院时间、费用和30天全因及与哮喘相关的再次入院风险增加。与非糖尿病患者相比，他们在住院期间发生非呼吸系统并发症的风险也更高。两组之间的死亡风险相似。
结论：合并DM的患者因哮喘住院的时间、费用和再次入院风险均增加。迫切需要采取干预措施来降低患有DM的哮喘患者的入院和再入院风险。这些干预将产生深远的经济和社会影响。
Diabetes Mellitus is Associated with Worse Outcome in Patients Hospitalized for Asthma.
Peng Zhang, Rocio Lopez, Amy H Attaway, Steve N Georas, Sumita B Khatri, Simon Abi-Saleh, Joe G Zein.
Abstract
BACKGROUND:Asthma is a prevalent disease with high economic cost. Over 50% of its direct cost relates to asthma hospitalizations. Diabetes mellitus (DM) is a significant comorbidity in asthmatic patients, yet its impact on asthma-related hospitalizations is unknown.
OBJECTIVE:To compare the outcome of asthma-related hospitalizations in patients with and without DM.
METHODS:Using Healthcare Cost and Utilization Project Nationwide Readmissions Database, we analyzed data of all adults with index admission for asthma and with no other chronic pulmonary conditions, and compared outcomes between patients with and without DM. Weighted regression analysis was used to determine the impact of DM on hospitalization outcomes. All multivariate regression models were adjusted for patient demographics, socioeconomic status and chronic medical comorbidities.
RESULTS:A total of 717,200 asthmatic patients were included, with 202,489 (28.3%) had DM. Diabetic patients were older and had more comorbidities. When hospitalized for asthma, diabetic patients had increased hospital length of stay, cost, and risk for 30-day all-cause and asthma-related readmission. They also had a higher risk for developing non-respiratory complications during their hospital stay compared to non-diabetics. The risk of mortality was similar between the two groups.
CONCLUSIONS:Patients hospitalized for asthma with coexisting DM had increased hospital length of stay, cost, and risk for readmission. Interventions are urgently needed to reduce the risk for hospital admission and readmission in patients with co-existing DM and asthma. These interventions would have profound economic and societal impact.
背景：哮喘是一种具有高经济成本的流行疾病。直接费用的50％以上与哮喘住院有关。糖尿病（DM）在哮喘患者中是一种重要的合并症，但对哮喘相关住院的影响尚不清楚。
目的：比较有无糖尿病的哮喘患者住院治疗的结局。
方法：我们使用“医疗保健费用和利用项目”全国再入院数据库，分析了所有有哮喘但无其他慢性肺病的成年住院患者的数据，并比较了患有和不患有DM的患者的结局。加权回归分析用于确定糖尿病对住院结局的影响。所有多元回归模型都针对患者的人口统计学，社会经济状况和慢性合并症进行了调整。
结果：研究总共纳入717,200名哮喘患者，其中202,489名（28.3％）患有DM。糖尿病患者年龄较大，合并症更多。当因哮喘住院时，糖尿病患者的住院时间、费用和30天全因及与哮喘相关的再次入院风险增加。与非糖尿病患者相比，他们在住院期间发生非呼吸系统并发症的风险也更高。两组之间的死亡风险相似。
结论：合并DM的患者因哮喘住院的时间、费用和再次入院风险均增加。迫切需要采取干预措施来降低患有DM的哮喘患者的入院和再入院风险。这些干预将产生深远的经济和社会影响。
(中日友好医院呼吸与危重症医学科 顾宪民 摘译 林江涛 审校)
(J Allergy Clin Immunol Pract. 2020 Nov 9;S2213-2198(20)31209-5. doi: 10.1016/j.jaip.2020.10.054.)
(J Allergy Clin Immunol Pract. 2020 Nov 9;S2213-2198(20)31209-5. doi: 10.1016/j.jaip.2020.10.054.)
Diabetes Mellitus is Associated with Worse Outcome in Patients Hospitalized for Asthma.
Peng Zhang, Rocio Lopez, Amy H Attaway, Steve N Georas, Sumita B Khatri, Simon Abi-Saleh, Joe G Zein.
Abstract
BACKGROUND:Asthma is a prevalent disease with high economic cost. Over 50% of its direct cost relates to asthma hospitalizations. Diabetes mellitus (DM) is a significant comorbidity in asthmatic patients, yet its impact on asthma-related hospitalizations is unknown.
OBJECTIVE:To compare the outcome of asthma-related hospitalizations in patients with and without DM.
METHODS:Using Healthcare Cost and Utilization Project Nationwide Readmissions Database, we analyzed data of all adults with index admission for asthma and with no other chronic pulmonary conditions, and compared outcomes between patients with and without DM. Weighted regression analysis was used to determine the impact of DM on hospitalization outcomes. All multivariate regression models were adjusted for patient demographics, socioeconomic status and chronic medical comorbidities.
RESULTS:A total of 717,200 asthmatic patients were included, with 202,489 (28.3%) had DM. Diabetic patients were older and had more comorbidities. When hospitalized for asthma, diabetic patients had increased hospital length of stay, cost, and risk for 30-day all-cause and asthma-related readmission. They also had a higher risk for developing non-respiratory complications during their hospital stay compared to non-diabetics. The risk of mortality was similar between the two groups.
CONCLUSIONS:Patients hospitalized for asthma with coexisting DM had increased hospital length of stay, cost, and risk for readmission. Interventions are urgently needed to reduce the risk for hospital admission and readmission in patients with co-existing DM and asthma. These interventions would have profound economic and societal impact.
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