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Multicenter Study
. 2017 Dec 5;17(9):e7097.
doi: 10.5867/medwave.2017.09.7097.

Factors associated to inpatient mortality rates in type-2-diabetic patients: a cross-sectional analytical study in three Peruvian hospitals

[Article in Spanish, English]
Noé Atamari-Anahui  1 , Franklin W Martinez-Ninanqui  2 , Liz Paucar-Tito  3 , Luz Morales-Concha  3 , Alejandra Miranda-Chirau  3 , Marco Antonio Gamarra-Contreras  4 , Carlos Antonio Zea-Nuñez  5 , Christian R Mejia  6
Affiliations
Multicenter Study

Factors associated to inpatient mortality rates in type-2-diabetic patients: a cross-sectional analytical study in three Peruvian hospitals

[Article in Spanish, English]
Noé Atamari-Anahui et al. Medwave. .

Abstract
in English, Spanish

Introduction: Diabetes mortality has increased in recent years. In Peru, there are few studies on in-hospital mortality due to type 2 diabetes in the provinces.

Objective: To determine factors associated to hospital mortality in patients with diabetes mellitus type 2 in three hospitals from Cusco-Peru.

Methods: An analytical cross-sectional study was performed. All patients with diabetes mellitus type 2 hospitalized in the city of Cusco during the 2016 were included. Socio-educational and clinical characteristics were evaluated, with "death" as the variable of interest. The crude (cPR) and adjusted (aPR) prevalence ratios were estimated using generalized linear models with Poisson family and log link function, with their respective 95% confidence intervals (95% CI). The values p <0.05 were considered significant.

Results: A total of 153 patients were studied; 33.3% (51) died in the hospital. The mortality rate increased when the following factors were associated: age of the patients increased the mortality rate by one-year increments (aPR: 1.02; CI95%: 1.01-1.03; p<0.001); to have been admitted by the emergency service (aPR: 1.93; CI95%: 1.34-2.77; p<0.001); being a patient who is readmitted to the hospital (aPR: 2.01; CI95%: 1.36-2.98; p<0.001); and patients who have had a metabolic in-hospital complication (aPR: 1.61; CI95%: 1.07-2.43; p=0.024) or renal in-hospital complications (aPR: 1.47; CI95%: 1.30-1.67; p<0.001). Conversely, the mortality rate was reduced when admission was due to a urinary tract infection (aPR: 0.50; CI95%: 0.35-0.72; p<0.001); adjusted by seven variables.

Conclusions: A third of hospitalized diabetes mellitus type 2 patients died during the study period. Mortality was increased as age rises, patients admitted through emergency rooms, patients who were readmitted to the hospital, and patients who had metabolic or renal complications. Patients admitted for a urinary tract infection had a lower mortality rate.

Introducción: La mortalidad por diabetes se ha incrementado en los últimos años. En Perú, existen escasos estudios acerca de la mortalidad intrahospitalaria por diabetes en provincias.

Objetivos: Determinar los factores asociados a mortalidad intrahospitalaria en pacientes con diabetes mellitus tipo 2 en tres hospitales de la sierra sur del Perú.

Métodos: Se realizó un estudio de corte transversal analítico. Se incluyó a todos los pacientes con diabetes mellitus tipo 2 hospitalizados en la ciudad del Cusco durante el año 2016. Se evaluó las características socioeducativas y clínicas, teniendo a la “defunción” como variable de interés. Se calculó las razones de prevalencias crudas y ajustadas, mediante los modelos lineales generalizados, con familia Poisson y función de enlace log, con sus respectivos intervalos de confianza al 95%. Se consideró significativos los valores p < 0,05.

Resultados: De los 153 pacientes, el 33,3% (51) murió en la hospitalización. Incrementó la frecuencia de mortalidad: por cada año de edad del paciente (razón de prevalencias ajustada 1,02; intervalo de confianza 95%: 1,01 a 1,03; valor p < 0,001), por haber ingresado por el servicio de emergencia (razón de prevalencias ajustada 1,93; intervalo de confianza 95%: 1,34 a 2,77; valor p < 0,001), por ser un paciente que reingresa al hospital (razón de prevalencias ajustada 2,01; intervalo de confianza 95%: 1,36 a 2,98; valor p < 0,001) y por haber tenido una complicación hospitalaria metabólica (razón de prevalencias ajustada 1,61; intervalo de confianza 95%: 1,07 a 2,43; valor p = 0,024) o renal (razón de prevalencias ajustada 1,47; intervalo de confianza 95%: 1,30 a 1,67; valor p < 0,001). En cambio, disminuyó la frecuencia mortalidad el que su causa de hospitalización haya sido por una infección del tracto urinario (razón de prevalencia ajustada 0,50; intervalo de confianza 95%: 0,35 a 0,72; valor p < 0,001); ajustado por siete variables.

Conclusiones: La edad, el ingresar por emergencia y el presentar reingresos a la hospitalización fueron factores asociados a mortalidad; así como el presentar complicaciones intrahospitalarias de tipo metabólica o renal.

Keywords: Peru; hospitals; mortality; type 2 diabetes mellitus.

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