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Temporal Trend in Hospitalizations for Acute Diabetic Complications: A Nationwide Study, Italy, 2001–2010

BACKGROUND: We investigated temporal trends and geographic variations in both hospitalizations and in-hospital mortality rates for acute diabetic complications (ADC) in the Italian universal health care system. METHODS AND FINDINGS: A retrospective review of the medical records of patients with eith...

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Autores principales: Lombardo, Flavia, Maggini, Marina, Gruden, Gabriella, Bruno, Graziella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3662780/
https://www.ncbi.nlm.nih.gov/pubmed/23717464
http://dx.doi.org/10.1371/journal.pone.0063675
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author Lombardo, Flavia
Maggini, Marina
Gruden, Gabriella
Bruno, Graziella
author_facet Lombardo, Flavia
Maggini, Marina
Gruden, Gabriella
Bruno, Graziella
author_sort Lombardo, Flavia
collection PubMed
description BACKGROUND: We investigated temporal trends and geographic variations in both hospitalizations and in-hospital mortality rates for acute diabetic complications (ADC) in the Italian universal health care system. METHODS AND FINDINGS: A retrospective review of the medical records of patients with either primary or secondary discharge diagnosis of hyperglycaemic acute complications (ICD-9-CM codes 250.1, 250.2, 250.3) or hypoglycemic coma (ICD-9-CM code 251.0) was performed in period 2001–2010. Standardized rates by age and gender on 2001 Italian population and by diabetic population were calculated. We identified 7,601.883 diabetes-related hospital discharges. Out of them, 266,374 (3.5%) were due to ADC, either ketoacidosis/hyperosmolarity (94.4%) or hypoglycemic coma (5.6%). The rate of discharge for ADC decreased by 51.1% from 2001 to 2010 (14.4 vs. 7.1 discharge rate/1,000 diabetic people; 5.7% decrease per year, test for trend, p<0.001) with a similar trend for both hyperglycemic and hypoglycemic complications. Diabetic people in the younger age groups (≤19 and 20–44 years old) had a significantly greater rate of discharge for ADC than people aged 65 years and over (≤19 10-fold increase; 20–44: 2-fold increase). In-hospital mortality rate was 7.6%, with 211 preventable deaths in younger diabetic people (≤44 years old). There was a large variability among Italian Regions and the ratio between the highest and the lowest regional discharge rate reached 300% in 2010. CONCLUSIONS: Decreasing temporal trend in hospitalizations for preventable ADC suggests improving outpatient care. In younger diabetic patients, however, both hospitalization rates and in-hospital mortality are still a matter of concern.
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spelling pubmed-36627802013-05-28 Temporal Trend in Hospitalizations for Acute Diabetic Complications: A Nationwide Study, Italy, 2001–2010 Lombardo, Flavia Maggini, Marina Gruden, Gabriella Bruno, Graziella PLoS One Research Article BACKGROUND: We investigated temporal trends and geographic variations in both hospitalizations and in-hospital mortality rates for acute diabetic complications (ADC) in the Italian universal health care system. METHODS AND FINDINGS: A retrospective review of the medical records of patients with either primary or secondary discharge diagnosis of hyperglycaemic acute complications (ICD-9-CM codes 250.1, 250.2, 250.3) or hypoglycemic coma (ICD-9-CM code 251.0) was performed in period 2001–2010. Standardized rates by age and gender on 2001 Italian population and by diabetic population were calculated. We identified 7,601.883 diabetes-related hospital discharges. Out of them, 266,374 (3.5%) were due to ADC, either ketoacidosis/hyperosmolarity (94.4%) or hypoglycemic coma (5.6%). The rate of discharge for ADC decreased by 51.1% from 2001 to 2010 (14.4 vs. 7.1 discharge rate/1,000 diabetic people; 5.7% decrease per year, test for trend, p<0.001) with a similar trend for both hyperglycemic and hypoglycemic complications. Diabetic people in the younger age groups (≤19 and 20–44 years old) had a significantly greater rate of discharge for ADC than people aged 65 years and over (≤19 10-fold increase; 20–44: 2-fold increase). In-hospital mortality rate was 7.6%, with 211 preventable deaths in younger diabetic people (≤44 years old). There was a large variability among Italian Regions and the ratio between the highest and the lowest regional discharge rate reached 300% in 2010. CONCLUSIONS: Decreasing temporal trend in hospitalizations for preventable ADC suggests improving outpatient care. In younger diabetic patients, however, both hospitalization rates and in-hospital mortality are still a matter of concern. Public Library of Science 2013-05-23 /pmc/articles/PMC3662780/ /pubmed/23717464 http://dx.doi.org/10.1371/journal.pone.0063675 Text en © 2013 Lombardo et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Lombardo, Flavia
Maggini, Marina
Gruden, Gabriella
Bruno, Graziella
Temporal Trend in Hospitalizations for Acute Diabetic Complications: A Nationwide Study, Italy, 2001–2010
title Temporal Trend in Hospitalizations for Acute Diabetic Complications: A Nationwide Study, Italy, 2001–2010
title_full Temporal Trend in Hospitalizations for Acute Diabetic Complications: A Nationwide Study, Italy, 2001–2010
title_fullStr Temporal Trend in Hospitalizations for Acute Diabetic Complications: A Nationwide Study, Italy, 2001–2010
title_full_unstemmed Temporal Trend in Hospitalizations for Acute Diabetic Complications: A Nationwide Study, Italy, 2001–2010
title_short Temporal Trend in Hospitalizations for Acute Diabetic Complications: A Nationwide Study, Italy, 2001–2010
title_sort temporal trend in hospitalizations for acute diabetic complications: a nationwide study, italy, 2001–2010
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3662780/
https://www.ncbi.nlm.nih.gov/pubmed/23717464
http://dx.doi.org/10.1371/journal.pone.0063675
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