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Predicting mortality in people with Type 2 diabetes mellitus after major complications: a study using Swedish National Diabetes Register data

Kelly, P. J.; Clarke, P. M.; Hayes, A. J.; Gerdtham, Ulf LU ; Cederholm, J.; Nilsson, Peter LU ; Eliasson, B. and Gudbjornsdottir, S. (2014) In Diabetic Medicine 31(8). p.954-962
Abstract
Aim To predict mortality risk and life expectancy for patients with Type 2 diabetes after a major diabetes-related complication. Methods The study sample, taken from the Swedish National Diabetes Register, consisted of 20 836 people with Type 2 diabetes who had their first major complication (myocardial infarction, stroke, heart failure, amputation or renal failure) between January 2001 and December 2007. A Gompertz proportional hazards model was derived which determined significant risk factors associated with mortality and was used to estimate life expectancies. Results Risk of death changed over time according to type of complication, with myocardial infarction initally having the highest initial risk of death, but after the first... (More)
Aim To predict mortality risk and life expectancy for patients with Type 2 diabetes after a major diabetes-related complication. Methods The study sample, taken from the Swedish National Diabetes Register, consisted of 20 836 people with Type 2 diabetes who had their first major complication (myocardial infarction, stroke, heart failure, amputation or renal failure) between January 2001 and December 2007. A Gompertz proportional hazards model was derived which determined significant risk factors associated with mortality and was used to estimate life expectancies. Results Risk of death changed over time according to type of complication, with myocardial infarction initally having the highest initial risk of death, but after the first month, the risk was higher for heart failure, renal failure and amputation. Other factors that increased the risk of death were male gender (hazard ratio 1.06, 95% CI 1.02-1.12), longer duration of diabetes (hazard ratio 1.07 per 10 years, 95% CI 1.04-1.10), smoking (hazard ratio 1.51, 95% CI 1.40-1.63) and macroalbuminuria (hazard ratio 1.14, 95% CI 1.06-1.22). Low BMI, low systolic blood pressure and low estimated GFR also increased mortality risk. Life expectancy was highest after a stroke, myocardial infarction or heart failure, lower after amputation and lowest after renal failure. Smoking and poor renal function were the risk factors which had the largest impact on reducing life expectancy. Conclusions Risk of death and life expectancy differs substantially among the major complications of diabetes, and factors significantly increasing risk included smoking, low estimated GFR and albuminuria. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Diabetic Medicine
volume
31
issue
8
pages
954 - 962
publisher
Wiley-Blackwell
external identifiers
  • wos:000340666600011
  • scopus:84904327289
ISSN
1464-5491
DOI
10.1111/dme.12468
language
English
LU publication?
yes
id
8b5740f8-9f37-4651-b0b2-d451e0d0113d (old id 4652893)
date added to LUP
2014-09-24 15:20:15
date last changed
2017-11-12 03:35:14
@article{8b5740f8-9f37-4651-b0b2-d451e0d0113d,
  abstract     = {Aim To predict mortality risk and life expectancy for patients with Type 2 diabetes after a major diabetes-related complication. Methods The study sample, taken from the Swedish National Diabetes Register, consisted of 20 836 people with Type 2 diabetes who had their first major complication (myocardial infarction, stroke, heart failure, amputation or renal failure) between January 2001 and December 2007. A Gompertz proportional hazards model was derived which determined significant risk factors associated with mortality and was used to estimate life expectancies. Results Risk of death changed over time according to type of complication, with myocardial infarction initally having the highest initial risk of death, but after the first month, the risk was higher for heart failure, renal failure and amputation. Other factors that increased the risk of death were male gender (hazard ratio 1.06, 95% CI 1.02-1.12), longer duration of diabetes (hazard ratio 1.07 per 10 years, 95% CI 1.04-1.10), smoking (hazard ratio 1.51, 95% CI 1.40-1.63) and macroalbuminuria (hazard ratio 1.14, 95% CI 1.06-1.22). Low BMI, low systolic blood pressure and low estimated GFR also increased mortality risk. Life expectancy was highest after a stroke, myocardial infarction or heart failure, lower after amputation and lowest after renal failure. Smoking and poor renal function were the risk factors which had the largest impact on reducing life expectancy. Conclusions Risk of death and life expectancy differs substantially among the major complications of diabetes, and factors significantly increasing risk included smoking, low estimated GFR and albuminuria.},
  author       = {Kelly, P. J. and Clarke, P. M. and Hayes, A. J. and Gerdtham, Ulf and Cederholm, J. and Nilsson, Peter and Eliasson, B. and Gudbjornsdottir, S.},
  issn         = {1464-5491},
  language     = {eng},
  number       = {8},
  pages        = {954--962},
  publisher    = {Wiley-Blackwell},
  series       = {Diabetic Medicine},
  title        = {Predicting mortality in people with Type 2 diabetes mellitus after major complications: a study using Swedish National Diabetes Register data},
  url          = {http://dx.doi.org/10.1111/dme.12468},
  volume       = {31},
  year         = {2014},
}