Relationship between diabetes and mortality - A population study using record linkage

被引:135
作者
Morgan, CL [1 ]
Currie, CJ [1 ]
Peters, JR [1 ]
机构
[1] Univ Wales Hosp, Dept Gen Med, Cardiff CF4 4XW, S Glam, Wales
关键词
D O I
10.2337/diacare.23.8.1103
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE - To determine patterns and causes of mortality for patients with diabetes in a district health authority. RESEARCH DESIGN AND METHODS - The study used cross-sectional record linkage, combining an electronic death register with a diabetic patient register constructed from a variety of routine health data sources collected from 1991 to 1997. The study was conducted in Cardiff and the Vale of Glamorgan, Wales, U.K., and included all diabetic deaths between 1993 and 1996. RESULTS - Of 1,694 deaths in patients with known diabetes, only 674 (39.8%) had diabetes recorded as an immediate or antecedent cause of death. Mortality rates were 41.8 per 1,000 for the diabetic population and 10.1 per 1,000 for the nondiabetic population. The standard mean ratio for the diabetic population was 1.24 (95% CI 1.12-1.35), with the risk of mortality relative to the nondiabetic population decreasing with age. Males with diabetes lost an average of 7.0 years from the year of diagnosis, and females with diabetes lost an average of 7.5 years. The most common cause of death was cardiovascular disease, which accounted for 49.1% of deaths in the diabetic population. CONCLUSIONS - Diabetes is recorded as a cause of death on a minority of death certificates for patients with diabetes. Using death certificates in isolation, therefore, is a poor method of estimating diabetic mortality but results can be improved with the use of record linkage techniques. Patients with diabetes have an excess risk of mortality compared with the nondiabetic population. Life-years lost for patients with diabetes is strongly related to age at diagnosis and is a means of expressing mortality without relying on accurate prevalence data.
引用
收藏
页码:1103 / 1107
页数:5
相关论文
共 32 条
[1]   UNDERREPORTING OF DIABETES ON DEATH CERTIFICATES, KING COUNTY, WASHINGTON [J].
ANDRESEN, EM ;
LEE, JAH ;
PECORARO, RE ;
KOEPSELL, TD ;
HALLSTROM, AP ;
SISCOVICK, DS .
AMERICAN JOURNAL OF PUBLIC HEALTH, 1993, 83 (07) :1021-1024
[2]   CERTIFICATION OF CAUSE OF DEATH IN FRENCH DIABETIC-PATIENTS [J].
BALKAU, B ;
PAPOZ, L .
JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, 1992, 46 (01) :63-65
[3]   FREQUENCY OF RECORDING OF DIABETES ON UNITED-STATES DEATH CERTIFICATES - ANALYSIS OF THE 1986 NATIONAL MORTALITY FOLLOWBACK SURVEY [J].
BILD, DE ;
STEVENSON, JM .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 1992, 45 (03) :275-281
[4]   GLYCATED HEMOGLOBIN AND METABOLIC CONTROL OF DIABETES-MELLITUS - EXTERNAL VERSUS LOCALLY ESTABLISHED CLINICAL TARGETS FOR PRIMARY-CARE [J].
BUTLER, C ;
PETERS, J ;
STOTT, N .
BMJ-BRITISH MEDICAL JOURNAL, 1995, 310 (6982) :784-788
[5]  
BUTLER C, 1997, EUR J GEN PRACT, V3, P23
[6]   Diabetes mellitus and pancreatic cancer mortality in a prospective cohort of United States adults [J].
Calle, EE ;
Murphy, TK ;
Rodriguez, C ;
Thun, MJ ;
Heath, CW .
CANCER CAUSES & CONTROL, 1998, 9 (04) :403-410
[7]   THE MORTALITY OF ELDERLY PEOPLE WITH DIABETES [J].
CROXSON, SCM ;
PRICE, DE ;
BURDEN, M ;
JAGGER, C ;
BURDEN, AC .
DIABETIC MEDICINE, 1994, 11 (03) :250-252
[8]  
Currie CJ, 1997, DIABETIC MED, V14, P477, DOI 10.1002/(SICI)1096-9136(199706)14:6<477::AID-DIA379>3.0.CO
[9]  
2-9
[10]  
FULLER JH, 1983, DIABETOLOGIA, V24, P336