Predictors of mortality in hospitalized diabetic patients: A 7-year prospective study

This study was conducted to investigate the mortality rate, causes of death, and standardized mortality ratio (SMR), and to identify the significant predictive factors of mortality in diabetic patients at a medical center in Taiwan. Clinical data were obtained from 1792 diabetic inpatients discharged from the metabolism department of a medical center during the years 1996-2002. Underlying causes of death were determined from death certificates. Predictors of mortality were assessed by uni- and multivariate Cox survival analyses. Of 1792 patients studied, 410 (22.9%) patients died. The crude mortality rate was 93.2/1000 person-years, and the overall SMR was 2.98 (2.71-3.28). The percentages of causes of death ascribed to diabetes, cancer, cardiopulmonary disease, infection, stroke, digestive diseases, nephropathy, accidents, suicide, and disease of arteries, arterioles, and capillaries were 38.0, 13.2, 9.5, 7.8, 7.6, 6.8, 5.1, 2.0, 0.5, and 0.2%, respectively. The independent predictors of mortality were age greater than 65, duration of hypertension more than 5 years, 24 h proteinuria greater than 0.3 g, and estimated creatinine clearance less than 60 mL/min. Conclusion: The mortality of diabetic inpatients was about threefold that of the general population. The predictors of mortality included older age, longer duration of hypertension, increased 24 h proteinuria, and decreased creatinine clearance.