Causes of in-hospital death in patients with type 2 diabetes with micro- and macrovascular complications in Taiwan.

Tu, Ching-Ling; Sue, Shu-Ping; Hsu, Wei-Hao; Huang, Hsing-Yi; Wen, Wei-Lun; Lin, I-Ting; Chen, Kuan-Hsuan; Sheu, Nai-Wei; Huang, Shu-Heng; Lee, Mei-Yueh

AIMS Diabetes mellitus is a major cause of death worldwide, including Taiwan. The mortality data of the subsets of patients who suffered from micro- or macrovascular complications is limited. The aim of this study was to investigate the causes of in-hospital death of patients with type 2 diabetes, especially the patients with microvascular, macrovascular and, both micro-macrovascular complications. METHODS A total of 12,159 patients with type 2 diabetes were identified from the Taiwan National Health Insurance Research Database (NHIRD) to analyze the causes of death. Type 2 diabetic subjects with microvascular, macrovascular and both micro-macrovascular complications were further classified and compared to patients without micro- and macrovascular complications in the logistic regression analysis of the risk of death. RESULTS Pneumonia increased risk of in-hospital death in patients with microvascular, macrovascular and both micro-macrovascular complications, with adjusted odds ratios (AORs) of 2.13 (95% confidence interval [CI] 1.09-4.18), 3.26 (1.71-6.24) and 3.96 (2.17-7.22), respectively. Septicemia increased risk of in-hospital death in patients with macrovascular (AOR 2.57 (1.31-5.04)) and both micro-macrovascular complications (AOR 4.69 (2.58-8.50). CONCLUSION Pneumonia increased risk of in-hospital death among the type 2 diabetic patients with microvascular, macrovascular and both micro-macrovascular complications. Therefore, efforts aim at preventing pneumonia or decreasing its severity may increase survival.