Diabetic Patients with Severe Sepsis Admitted to Intensive Care Unit Do Not Fare Worse than Non-Diabetic Patients: A Nationwide Population-Based Cohort Study

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Title:	Diabetic Patients with Severe Sepsis Admitted to Intensive Care Unit Do Not Fare Worse than Non-Diabetic Patients: A Nationwide Population-Based Cohort Study
Authors:	洪炯宗;Chang, Cheng-Wei;Kok, Victor C.;Tseng, Ta-Chien;Horng, Jorng-Tzong;Liu, Chun-Eng
Contributors:	資訊電機學院資訊工程學系
Keywords:	Adult;Aged;Aged, 80 and over;Ambulatory care;Ambulatory care facilities;Analysis;Biology;Care and treatment;Cohort analysis;Cohort Studies;Comorbidity;Confidence intervals;Diabetes;Diabetes mellitus;Diabetes Mellitus, Type 2 - mortality;Diabetics;Dialysis;Female;Health insurance;Health risks;Hematology;Hemodialysis;Hospital Mortality;Hospitalization;Hospitals;Humans;Infection;Informatics;Intensive care;Intensive Care Units;Internal medicine;Kidneys;Length of Stay;Male;Medical research;Medicine;Middle Aged;Mortality;Multiple Organ Failure - mortality;Patients;Population;Population studies;Population-based studies;Prognosis;Public health;Regression analysis;Researchers;Resource utilization;Risk;Sepsis;Sepsis - mortality;Social and Behavioral Sciences;Statistical analysis;Surgery;Taiwan - epidemiology;Type 2 diabetes
Date:	2012-12-07
Issue Date:	2026-04-23 13:31:48 (UTC+8)
Publisher:	Public Library of Science;United States: Public Library of Science
Abstract:	摘要： We sought to examine whether type 2 diabetes increases the risk of acute organ dysfunction and of hospital mortality following severe sepsis that requires admission to an intensive care unit (ICU). Nationwide population-based retrospective cohort study of 16,497 subjects with severe sepsis who had been admitted for the first time to an ICU during the period of 1998-2008. A diabetic cohort (n = 4573) and a non-diabetic cohort (n = 11924) were then created. Relative risk (RR) of organ dysfunctions, length of hospital stay (LOS), 90-days hospital mortality, ICU resource utilization and hazard ratio (HR) of mortality adjusted for age, gender, Charlson-Deyo comorbidity index score, surgical condition and number of acute organ dysfunction, were compared across patients with severe sepsis with or without diabetes. Diabetic patients with sepsis had a higher risk of developing acute kidney injury (RR, 1.54; 95% confidence interval (CI), 1.44-1.63) and were more likely to be undergoing hemodialysis (15.55% vs. 7.24%) in the ICU. However, the diabetic cohort had a lower risk of developing acute respiratory dysfunction (RR = 0.96, 0.94-0.97), hematological dysfunction (RR = 0.70, 0.56-0.89), and hepatic dysfunction (RR = 0.77, 0.63-0.93). In terms of adjusted HR for 90-days hospital mortality, the diabetic patients with severe sepsis did not fare significantly worse when afflicted with cardiovascular, respiratory, hepatic, renal and/or neurologic organ dysfunction and by numbers of organ dysfunction. There was no statistically significant difference in LOS between the two cohorts (median 17 vs. 16 days, interquartile range (IQR) 8-30 days, p = 0.11). Multiple logistic regression analysis to predict the occurrence of mortality shows that being diabetic was not a predictive factor with an odds ratio of 0.972, 95% CI 0.890-1.061, p = 0.5203. This large nationwide population-based cohort study suggests that diabetic patients do not fare worse than non-diabetic patients when suffering from severe sepsis that requires ICU admission. 其他題名： PLoS One 出版者： United States: Public Library of Science 出版日期： 2012-12-07 出處： PloS one, 2012-12, Vol.7 (12), p.e50729 資源來源： Agricultural & Environmental Science Collection 版權： COPYRIGHT 2012 Public Library of Science 版權： 2012 Chang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 版權： 2012 Chang et al 2012 Chang et al 識別號： ISSN: 1932-6203 識別號： EISSN: 1932-6203 識別號： DOI: 10.1371/journal.pone.0050729 識別號： PMID: 23236389
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