Xihua Mao1, Chen Liang1, Hongtao Niu2,3,4, Fen Dong2,3,4,5, Ke Huang2,3,4, Yahong Chen6, Kewu Huang7,8, Qingyuan Zhan2,3,4, Yaowen Zhang1, Yin Huang1, Ting Yang9,10,11, Chen Wang12,13,14,15. 1. Chinese Alliance for Respiratory Diseases in Primary Care, Beijing, China. 2. Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No 2, East Yinghua Road, Chaoyang District, Beijing, 100029, China. 3. National Clinical Research Center for Respiratory Diseases, Beijing, China. 4. Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, China. 5. Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China. 6. Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China. 7. Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Beijing, China. 8. Department of Respiratory Medicine, Capital Medical University, Beijing, China. 9. Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No 2, East Yinghua Road, Chaoyang District, Beijing, 100029, China. zryyyangting@163.com. 10. National Clinical Research Center for Respiratory Diseases, Beijing, China. zryyyangting@163.com. 11. Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, China. zryyyangting@163.com. 12. Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, No 2, East Yinghua Road, Chaoyang District, Beijing, 100029, China. cyh-birm@263.net. 13. National Clinical Research Center for Respiratory Diseases, Beijing, China. cyh-birm@263.net. 14. Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, China. cyh-birm@263.net. 15. Chinese Academy of Medical Sciences and Peking Union Medical College, 9 Dongdan 3rd Alley, Dong Dan, Dongcheng, Beijing, 100730, China. cyh-birm@263.net.
Abstract
BACKGROUND: Diabetes is a common comorbidity among patients with exacerbation of chronic obstructive pulmonary disease (AECOPD). Diabetes has been reported to be associated with length of stay (LOS), death, and cost among AECOPD patients. However, most studies are retrospective or have small sample sizes. The association for cost has not been researched using diabetes as a main analytic factor. This study aimed to fill gaps mentioned above, to compare basic characteristics between the diabetic and non-diabetic group, and to detect associations between diabetes and clinical outcomes among patients hospitalized with AECOPD. METHODS: A total of 5334 AECOPD patients, classified into diabetic and non-diabetic group, were included from a prospective multicenter patient registry study. Generalized linear regression and logistic regression were separately used for the association between diabetes and direct hospitalization cost and the association between diabetes and LOS. RESULTS: Generally, diabetic patients had a more severe profile, including being older, more overweight or obese, having more former smokers, more emergency room visits in the past 12 months, and more comorbidities occurrence. Diabetic patients also had worse clinical outcomes, including higher cost and longer LOS. Additionally, the generalized linear regression indicated that the marginal mean cost difference between diabetic and non-diabetic patients was RMB (¥) 775.7. CONCLUSIONS: AECOPD patients with comorbid diabetes had a more severe profile and higher direct hospitalization cost. Diabetes screening and integrated care programs might help reduce the heavy comorbidity and economic burden. Moreover, corticosteroids and metformin could be considered in the treatment of these patients. Trial registration Clinicaltrials.gov with the identifier NCT0265752.
BACKGROUND:Diabetes is a common comorbidity among patients with exacerbation of chronic obstructive pulmonary disease (AECOPD). Diabetes has been reported to be associated with length of stay (LOS), death, and cost among AECOPDpatients. However, most studies are retrospective or have small sample sizes. The association for cost has not been researched using diabetes as a main analytic factor. This study aimed to fill gaps mentioned above, to compare basic characteristics between the diabetic and non-diabetic group, and to detect associations between diabetes and clinical outcomes among patients hospitalized with AECOPD. METHODS: A total of 5334 AECOPDpatients, classified into diabetic and non-diabetic group, were included from a prospective multicenter patient registry study. Generalized linear regression and logistic regression were separately used for the association between diabetes and direct hospitalization cost and the association between diabetes and LOS. RESULTS: Generally, diabeticpatients had a more severe profile, including being older, more overweight or obese, having more former smokers, more emergency room visits in the past 12 months, and more comorbidities occurrence. Diabeticpatients also had worse clinical outcomes, including higher cost and longer LOS. Additionally, the generalized linear regression indicated that the marginal mean cost difference between diabetic and non-diabeticpatients was RMB (¥) 775.7. CONCLUSIONS:AECOPDpatients with comorbid diabetes had a more severe profile and higher direct hospitalization cost. Diabetes screening and integrated care programs might help reduce the heavy comorbidity and economic burden. Moreover, corticosteroids and metformin could be considered in the treatment of these patients. Trial registration Clinicaltrials.gov with the identifier NCT0265752.
Authors: C Terzano; V Colamesta; B Unim; S Romani; A Meneghini; G Volpe; G La Torre Journal: Eur Rev Med Pharmacol Sci Date: 2017-08 Impact factor: 3.507