SURVEILLANCE OF MORTALITY: FROM A TERTIARY CARE TEACHING HOSPITAL OF EASTERN INDIA IN PERSONS WITH AND WITHOUT DIABETES MELLITUS
Keywords:Diabetes mellitus, Infection, Morbidity, Mortality
Objective: There is abundant knowledge about the gravity of global load of diabetes mellitus (DM). There are conflicting reports on the cause of death from different parts of the world. In India, there are not enough studies to establish the cause of death in DM. To find out the mortality pattern in DM and non-DM (NDM) in a tertiary care teaching hospital in Eastern India.
Methods: Retrospective analysis of in-hospital mortality in a tertiary care hospital in Eastern India, from January 2012 to December 2015.
Results: There were a total of 1590 deaths of which 442 were having DM and 1148 did not have DM (NDM). Mean age of death for nondiabetics was 66.4 years (M:F = 67.5:65.3) and that for diabetics were 62.7 years (M:F = 63.5:60.04) which was not statistically significant (p=0.9) though diabetics died younger by 4 years. On analyzing the specific cause of death, coronary artery disease (CAD) was 14.71% in DM and 1.57% in NDM (p=0.0001). Chronic kidney disease (CKD) was 18.55% in DM and 1.92% in NDM (p=0.0001). Congestive heart failure was 7.27% in DM and 1.83% in NDM (p=0.0001). CVA was 13.57% in DM and 1.66% in NDM (p=0.0001). Infection was the most common cause of death (39.37%) in DM, but in NDM also this was quite high 34.41% (p=0.21). The death due to CVA in DM was more in hemorrhage as compared to ischemic (p=0.00001).
Conclusion: We found causes of death in DM were an infection, CKD, CAD, CVA, and CHF in descending order in this part of the world. The diabetes patients had lesser hospital stay than nondiabetes patients (p=0.009).
Ramachandran A, Snehalatha C, Kapur A, Vijay V, Mohan V, Das AK, et al. High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey. Diabetologia 2001;44(9):1094-101.
Pradeepa R, Deepa R, Mohan V. Epidemiology of diabetes in India - Current perspective and future projections. J Indian Med Assoc 2002;100(3):144-8.
World Health Organisation (WHO). Country and Regional da on Diabetes. Geneva: WHO; 2016.
Kapur A, Shishoo S, Ahuja MM, Sen V, Mankame K. Diabetes care in Indian/patients perceptions attitude and practices (DIPPAP-1) study. Int J Diabetes Dev 1997;17:2-12.
Rayappa PH, Raju KN, Kapur A, Bjork S, Sylvist C, Dilipkumar KM. Economic cost of diabetes care. Int J Diabetes Dev 1999;19:83-5.
World Development Report. Investigating in Health, World Development Indicators, World Bank. New York: Oxford University Press; 1993. p. 213-4.
Wingard LE, Cowie CC, Reiber G, Boyko E, Stern M, Bennet P. Heart disease and diabetes. In: Harris MI, editor. Diabetes in America. 2nd ed. Washington, DC: NIH Publication; 1995. p. 429-48.
Geiss LS, Herman WH, Smith PJ, Harris MI, Cowie CC, Reiber G, et al., editors. Mortality in noninsulin dependent diabetes mellitus. In: Diabetes in America. 2nd ed. Washington, DC: NIH Publication; 1995. p. 233-58.
Gu K, Cowie CC, Harris MI. Mortality in adults with or without diabetes in a national cohort of the US population, 1971-1993. Diabetes Care 1998;21:1138-45.
Palumbo PJ, Elvebaak LR, Chu CP, Conolly DC, Kirkland LT. Diabetes mellitus: Incidence, prevalence, survivorship and causes of death in Rochester. Diabetes 1976;25:566-73.
Pyorala K, Laakso M, PyoÂ¨raÂ¨la K, Teuscher A, editors. Diabetes in Epidemiological Perspective. Vol. 2. Edinburgh: Churchill Livingstone; 1983. p. 183-247.
Ochi JW, Melton LJ, Palumbo PJ, Chu CP. A population based study of diabetes mortality. Diabetes Care 1985;8:224-9.
Panzram G. Mortality and survival in Type 2 (Noninsulin-dependent) diabetes mellitus. Diabetologia 1987;30:123-31.
Sasaki A, Horiuchi N, Hasegawa K, Uehara M. Mortality and causes of death in Type 2 diabetic patients: A long term follow-up study in Osaka district, Japan. Diabetes Res Clin Pract 1989;7(1):33-40.
Zargar AH, Wani AI, Masoodi SR, Laway BA, Bashir MI. Mortality in diabetes mellitus--data from a developing region of the world. Diabetes Res Clin Pract 1999;43(1):67-74.
Moulik PK, Mtonga R, Gill GV. Amputation and mortality in new-onset diabetic foot ulcers stratified by etiology. Diabetes Care 2003;26(2):491-4.
World Health Organization. Annual of the International Statistical Classification of Diseases and Related Health Problems. 10th Revision. Geneva: World Health Organization; 1992.
Balkau B, Papoz L. Certification of cause of death in French diabetic patients. J Epidemiol Community Health 1992;46(1):63-5.
Sasaki A, Horiuchi N, Hasegawa K, Uehara M. The proportion of death certificates of diabetic patients that mentioned diabetes in Osaka district, Japan. Diabetes Res Clin Pract 1993;20:1021-4.
Anderrsen EM, Lea JA, Pecoraro RE, Koepsell TD, Hallstrom AP, Siscoviek DS. Under-reporting of diabetes on death certificates, King County, Washington. Am J Public Health 1993;83:1021-4.
Will JC, Vinicor F, Stevenson J. Recording of diabetes on death certificates. Has it improved? J Clin Epidemiol 2001;54:239-44.
National Diabetes Statistics: General Information and National Estimates on Diabetes in the United States. Deaths among People with Diabetes. Available from: http://www.niddk.nih.gov/health/diabetes/pubs/dmstats/dmstats. [Last accessed on 2002 Oct 08].
Das S, Mishra RK, Jena BB, Misra KC, Sarangi B. Mortality events amongst non-insulin-dependent diabetes mellitus patients in Orissa. J Assoc Phys India 1991;39:519-20.
Ahuja MM. Causes of death amongst diabetics. Int J Diabetes Dev Ctries 1994;14:111-2.
Sagner M, Arena R, McNeil A, Brahmam GN, Hills AP, De Silva HJ, et al. Creating a pro-active health care system to combat chronic diseases in Sri Lanka: The central role of preventive medicine and healthy lifestyle behaviors: An official policy statement of the European society of preventive medicine. Expert Rev Cardiovasc Ther 2016;14(10):1107-17.
Baan CA, Feskens EJ. Disease burden of diabetes mellitus Type II in the Netherlands: Incidence, prevalence and mortality. Ned Tijdschr Geneeskd 2001;145(35):1681-5.
Tan MH, Maclean DR. Epidemiology of diabetes mellitus in Canada. Clin Invest Med 1995;18:240-6.
Wei SY, Shin SJ, Chen JH, Chang JM, Sung MH, Lee YM, et al. Major causes of diabetic death at one hospital. Kaohsiung J Med Sci 1996;12(4):216-20.
Bisi H, Ruggeri GB, Longatto Filho A, Fernandes VS, De Camargo RY, Cravero NP. Study in necropsy material of cause-specific mortalityâ€ in diabetics, in SÃ£o Paulo-Brasil. Rev Paul Med 1993;111(1):299-304.
Nazarluqman H, Clee OS, Satyaswamy N, Da P. Meloidosis in Brunei - Epidemiological and clinical profile. Brunei Int Med J 1999;1:291-7.
Valdez R, Narayan KM, Geiss LS, Engelgau MM. Impact of diabetes mellitus on mortality associated with pneumonia and influenza among non-Hispanic black and white US adults. Am J Public Health 1999;89(11):1715-21.
Bouter KP, Diepersloot RJ, van Romunde LK, Uitslager R, Masurel N, Hoekstra JB, et al. Effect of epidemic influenza on ketoacidosis, pneumonia and death in diabetes mellitus: A hospital register survey of 1976-1979 in The Netherlands. Diabetes Res Clin Pract 1991;12(1):61-8.
Geiss LS, Thompson TJ. Are persons with diabetes more likely to die from pneumonia and influenza. Diabetes 1995;44:124A.
Koziel H, Koziel MJ. Pulmonary complications of diabetes mellitus. Pneumonia. Infect Dis Clin North Am 1995;9(1):65-96.
Dash RJ, Dash S, Virdi JS. Neutrophil function in diabetes: Effect of glycemic control. Presented in the 17th IDF Congress (Abstract No. P1436), Mexico City, November; 2000.
Mounika S, Keerthy V, Ramadasu P, Sanakayala BU, Chaitanya L. Prevalence of acute cardiac and renal complications in poorly controlled diabetics and role of clinical pharmacist in modifying disease outcome in a tertiary care hospital. Int J Pharm Pharm Sci 2015;7(6):92-6.
Manjusha S, Madhu P, Atmatam P, Amit M, Ronak S. Medication adherence to antidiabetic therapy in patients with Type 2 diabetes mellitus. Int J Pharm Pharm Sci 2014;6(2):564-70.
How to Cite
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.