Mortalitätsrate diabetischer und nicht diabetischer Intensivstationspatienten – Analyse relevanter Risikofaktoren mit Hilfe eines Cox-Regressionsmodells

Nikola Maria Christina Bauer, Eberhart, Leopold (Prof. Dr. Med.), Klinik Für Anästhesie Und Intensivtherapie
2015
The global prevalence of diabetes mellitus in the world's adult population is estimated to be 8.3 % and still continues to increase dramatically. Approximately one fourth of all diabetic patients in the United States are not diagnosed. Because of its multifactorial complications diabetes mellitus implicates a lot of challenges in patient care. The HbA1c-value is measured routinely in all critically ill patients to differentiate between stress hyperglycemia and exacerbation of diabetes mellitus.
more » ... diabetes mellitus. Hyperglycemia in critical illness has been associated with increased mortality under a variety of clinical conditions, most notably myocardial infarction, stroke and after major surgery. Methods: This prospective observational study included 1005 intensive care patients of the McGill University Health Center in Montreal between June 2011 and June 2012. The study was designed to investigate the association between abnormal HbA1c-values on admission to Intensive Care Unit with poor outcomes as well as the influence of other possible variables on mortality. The data was presented using Cox regression, Kaplan-Meier survival estimates and T-test. As secondary outcomes of this study the prevalences of known and unknown diabetes mellitus have been determined. In the context of subgroup analysis the mortality and mean survival time of cardiac surgery, other surgical and medical intensive care patients as well as diabetic and non-diabetic patients have been compared with each other. Moreover, variables with significant influence on the mortality of these groups have been investigated. Results: The prevalence of diabetes mellitus in this study was 26 %. 6,3 % of the intensive care patients showed an undiagnosed diabetes mellitus. Within the scope of Kaplan-Meier estimates and T-test it was demonstrated that diabetic patients had h [...]
doi:10.17192/z2015.0627 fatcat:u5ksd5yjqze3hccqzlhkxex57u