title: Hospitalization for Hypoglycemia in Japanese Diabetic Patients: A Retrospective Study Using a National Inpatient Database, 2008-2012.
abstract: We aimed to elucidate the epidemiology, patient demographics, and clinical outcomes of hospitalization for hypoglycemia in diabetic patients using a Japanese large-scale database.We conducted a retrospective study using a national inpatient database of acute care hospitals in Japan. Diabetic patients ages ≥15 years with hypoglycemia as a main diagnosis for hospitalization were eligible. We estimated the annual number of hospitalizations in Japan and compared the annual admission rate by age and treatment groups. We also analyzed the association between patient characteristics and in-hospital mortality.Among 22.7 million discharge records from July 2008 and March 2013, a total of 25,071 patients were eligible. The mean age was 73.4 years, and the mean body mass index (BMI) was 22.3  kg/m(2). The estimated annual hospitalization for hypoglycemia in Japan was ∼20,000. Annual admission rates for hypoglycemia per 1000 diabetic patients and 1000 diabetic patients receiving insulin or oral hypoglycemic agents were 2.1 and 4.1, respectively. Patients <40 years and >70 years old were at a higher risk of hospitalization. In-hospital mortality was 3.8%, and risk factors associated with poor survival were male sex, older age, lower bed capacity, community hospital, low BMI, coma at admission, and higher Charlson Comorbidity Index.To prevent severe hypoglycemia that leads to death and complications, individualized and careful glycemic control are important, especially in very old or young patients and in those with comorbid conditions or low BMI.
authors.affiliation: From the Department of Internal Medicine (AS, HH, HK, H Yanai), Kohnodai Hospital, National Center for Global Health and Medicine, Ichikawa, Chiba; Department of Clinical Epidemiology and Health Economics (H Yasunaga, HM), School of Public Health, Graduate School of Medicine, University of Tokyo; Department of Health Informatics and Policy (KF), Tokyo Medical and Dental University Graduate School of Medicine; Department of Diabetes, Endocrinology, and Metabolism (TT), Center Hospital, National Center for Global Health and Medicine; and Department of Public Health (AG), Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Akahito
authors.initials: A
authors.lastname: Sako
authors.forename: Hideo
authors.initials: H
authors.lastname: Yasunaga
authors.forename: Hiroki
authors.initials: H
authors.lastname: Matsui
authors.forename: Kiyohide
authors.initials: K
authors.lastname: Fushimi
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Hamasaki
authors.forename: Hisayuki
authors.initials: H
authors.lastname: Katsuyama
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Tsujimoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Goto
authors.forename: Hidekatsu
authors.initials: H
authors.lastname: Yanai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D048909:Diabetes Complications / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology* / Q000209:etiology; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents