老年糖尿病住院患者病死率及相关因素分析

Analysis of mortality trend and related factors for aged in-patients with diabetes mellitus

目的了解住院老年糖尿病患者病死率变化趋势及相关影响因素。方法收集2005-2014年住院死亡老年糖尿病患者病历信息,回顾性分析比较老年住院糖尿病患者病死率变化趋势及死因分布特征。结果共纳入死亡糖尿病患者1297例,其中老年患者1162例,老年组病死率为4.44%,远高于非老年组0.94%(P<0.001);男性病死率高于女性(5.22%对3.47%,P<0.001)。 10年间老年糖尿病患者病死率呈下降趋势(P<0.001),前5年病死率从4.75%下降至3.01%(P<0.001),后5年内病死率无明显差异。老年糖尿病前5位死因依次是感染(27.71%)、心血管疾病(25.22%)、肿瘤(21.34%)、脑血管疾病(10.41%)、糖尿病并发症(5.51%);其中,60~79岁组首位死因是心血管疾病,80岁以上组感染占第1位。与2005-2009年相比,2010-2014年住院老年糖尿病感染死因比重增加43.81%(22.60%对32.50%,P<0.001),在2010年后成为首位死因。结论2005-2014的10年住院老年糖尿病患者病死率呈下降趋势,2010年后趋于平稳。感染和心血管疾病是老年糖尿病患者的主要死因。提示除心血管疾病外,需要重视老年糖尿病患者的感染预防和及时控制。

Objective To find out the mortality trend and related factors in aged hospitalized patients with diabetes mellitus(DM). Methods The case information diabetic in patients who died during the period from 2005 to 2014 were collected and the mortality and causes of death were analyzed. Results From 2005 to 2014, 1297 diabetic patients died, and the mortality of elderly DM inpatients was 4.44%(1162 cases), significantly higher than that of the non-elderly of 0.94%(P<0.001). The death rate of elderly diabetic patients was significantly higher in males than in females(5.22% vs. 3.47%, P<0.001). The mortality of the aged diabetic patients decreased within 10 years(P<0.001), decreasing from 4.75% in 2005 to 3.01% in 2009(P<0.001) in the year of 2005-2009, while there were no differences in the year of 2010-2014. The main death causes of the aged diabetic in-patients were as follows: infections(27.71%), cardiovascular diseases(25.22%), tumor(21.34%), cerebral vascular diseases(10.41%) and diabetic complications(5.51%). The first death cause in the 60-79 yrs group was cardiovascular diseases, while in the ≥80 yrs group, it was infections. The constituent ratio of infection as death cause in the aged during 2010-2014 significantly increased(22.60% vs. 32.50%, P<0.001), increasing by 43.81%, and it became the first cause of death in 2010. Conclusion The death rate of the elderly DM in-patients has decreased significantly within 10 years, from 2005 to 2014, while the rate has kept steady from 2010. Infections and cardiovascular diseases are the main cause of death. So it’s important to prevent the elderly hospitalized DM patients from infection, in addition to cardiovascular diseases, and to control in time.