Factors associated with in-hospital mortality among patients with diabetes admitted for lower extremity infections / Journal of the ASEAN Federation of Endocrine Societies

ABSTRACT

@#<p><strong>OBJECTIVE:</strong> To determine the factors associated with in-hospital mortality among diabetic patients admitted for lower extremity infection.</p><p><strong>METHODOLOGY:</strong> This is a retrospective analysis of diabetic patients with lower extremity infection admitted at the UP-Philippine General Hospital. Data was analyzed through multiple logistic regression after multiple imputation was performed for missing data.</p><p><strong>RESULTS:</strong> 441 patients with diabetes were included in the analysis, of which 98.1% have Type 2 diabetes mellitus; 58.1% were males and the mean age of the cohort was 56.7 ±11.1 years. The mortality rate was 11.1% over the 3-year period from 2015 to 2017, of which 46% died from myocardial infarction (MI). Multivariate logistic regression showed the following were associated with increased likelihood of in-hospital mortality non-performance of surgery (OR=4.22, 95%CI 1.10-16.27, p=0.036), elevated BUN (OR=1.06, 95%CI 1.01-1.11, p=0.016), MI (OR=27.19, 95%CI 6.38-115.94, p=0.000), respiratory failure requiring mechanical ventilation (OR=26.14, 95%CI 6.28-108.80, p=0.000), gastrointestinal bleeding (OR=10.08, 95%CI 1.87-54.38, p=0.007), hospital-acquired pneumonia (OR=9.46, 95%CI 2.52-35.51, p=0.001) and shock (OR=7.09, 95%CI 2.17-23.22, p=0.001).</p><p><strong>CONCLUSION:</strong> In the in-patient setting, morbidity and mortality is high among diabetic patients with lower extremity infection. Non-performance of surgery, elevated BUN, MI, respiratory failure requiring mechanical ventilation, gastrointestinal bleeding, hospital acquired pneumonia and shock are associated with in-hospital death.</p>