The Association between Diabetes Mellitus and Keratoplasty in Poland in the Years 2013–2017
Abstract
:1. Introduction
2. Material and methods
2.1. Data Sources, Disease Codes, and Definitions
2.2. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
Indication | Indication ICD-10 |
---|---|
Ocular surface diseases | H18.8 |
Bullous keratopathy | H18.1 |
Infectious keratitis and corneal ulcers | H16.0, H16.2, H16.3, H16.8, H16.9 |
Keratoconus | H18.6 |
Leucoma and corneal scars | H17.8, H17.9, H17.1 |
Corneal pigmentations and deposits | H18.0 |
Corneal dystrophies incl. Fuchs’s dystrophy | H18.5 |
Band keratopathy | H18.4 |
Other | - |
Appendix B
Comorbidity Variable | Comorbidity Group (ICD-10 Codes) | |
---|---|---|
1 | AIDS/HIV | B20, B21, B22, B24 |
2 | Alcohol abuse | F10, E52, G62.1, I42.6, K29.2, K70.0, K70.3, K70.9, T51, Z50.2, Z71.4, Z72.1 |
3 | Blood loss anemia | D50.0 |
4 | Arrhythmias | I44.1, I44.2, I44.3, I45.6, I45.9, I47–I49, R00.0, R00.1, R00.8, T82.1, Z45.0, Z95.0 |
5 | Chronic pulmonary disease | I27.8, I27.9, J40–J47, J60–J67, J68.4, J70.1, J70.3 |
6 | Coagulopathy | D65, D66, D67, D68, D69.1, D69.3, D69.4, D69.5, D69.6 |
7 | Congestive heart failure | I09.9, I11.0, I13.0, I13.2, I25.5, I42.0, I42.5, I42.6, I42.7, I42.8, I42.9, I43, I50, P29.0 |
8 | Deficiency anemia | D50.8, D50.9, D51, D52, D53 |
9 | Depression | F20.4, F31.3, F31.4, F31.5, F32, F33, F34.1, F41.2, F43.2 |
10 | Diabetes, Type 1 | E10 confirmed with purchased medications |
11 | Diabetes, Type 2 | E11 confirmed with purchased medications |
12 | Drug abuse | F11, F12, F13, F14, F15, F16, F18, F19, Z71.5, Z72.2 |
13 | Fluid and electrolyte disorders | E22.2, E86, E87 |
14 | Hypertension | I10, I11, I12, I13, I15 |
15 | Hypothyroidism | E00, E01, E02, E03, E89.0 |
16 | Liver disease | B18, I85, I86.4, I98.2, K70, K71.1, K71.3–K71.5, K71.7, K72–K74, K76.0, K76.2–K76.9, Z94.4 |
17 | Lymphoma | C81, C82, C83, C84, C85, C88, C96, C90.0, C90.2 |
18 | Metastatic cancer | C77, C78, C79, C80 |
19 | Obesity | E66 |
20 | Other neurological disorders | G10–G13, G20–G22, G25.4, G25.5, G31.2, G31.8, G31.9, G32, G35–G37, G40, G41, G93.1, G93.4, R47.0, R56 |
21 | Paralysis | G04.1, G11.4, G80.1, G80.2, G81, G82, G83.0, G83.1, G83.2, G83.3, G83.4, G83.9 |
22 | Peptic ulcer disease excluding bleeding | K25.7, K25.9, K26.7, K26.9, K27.7, K27.9, K28.7, K28.9 |
23 | Peripheral vascular disorders | I70, I71, I73.1, I73.8, I73.9, I77.1, I79.0, I79.2, K55.1, K55.8, K55.9, K95.8, Z95.9 |
24 | Psychoses | F20, F22, F23, F24, F25, F28, F29, F30.2, F31.2, F31.5 |
25 | Pulmonary circulation disorders | I26, I27, I28.0, I28.8, I28.9 |
26 | Renal failure | I12.0, I13.1, N18, N19, N25.0, Z49.0, Z49.1, Z49.2, Z94.0, Z99.2 |
27 | Rheumatoid arthritis/collagen vascular diseases | L94.0, L94.1, L94.3, M05, M06, M08, M12.0, M12.3, M30, M31.0–M31.3, M32–M35, M45, M46.1, M46.8, M46.9 |
28 | Solid tumor without metastasis | C00–C26, C30–C34, C37–C41, C43, C45–C58, C60–C76, C97 |
29 | Valvular disease | A52.0, I05–I08, I09.1, I09.8, I34–I39, Q23.0–Q23.3, Z95.2, Z95.3, Z95.4 |
30 | Weight loss | E40–E46, R63.4, R64 |
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2013 | 2014 | 2015 | 2016 | 2017 | All (Average) | |
---|---|---|---|---|---|---|
Age 0–18 | 7,431,731 | 7,367,066 | 7,309,001 | 7,286,480 | 7,299,996 | 7,338,855 |
DM in the subgroup, % | 0.18% | 0.19% | 0.20% | 0.21% | 0.22% | 0.20% |
No. of corneal grafts | 27 | 33 | 17 | 35 | 18 | 130 |
Incidence/100,000 person-yrs | 0.36 | 0.45 | 0.23 | 0.48 | 0.25 | 0.35 |
DM, % | 0.00% | 0.00% | 0.00% | 2.86% | 0.00% | 0.57% |
Age 19–39 | 12,355,235 | 12,201,430 | 12,015,345 | 11,799,562 | 11,570,164 | 11,988,347 |
DM in the subgroup, % | 0.58% | 0.68% | 0.79% | 0.90% | 1.01% | 0.79% |
fNo. of corneal grafts | 124 | 106 | 117 | 167 | 164 | 678 |
Incidence/100,000 person-yrs | 1.00 | 0.87 | 0.97 | 1.42 | 1.42 | 1.14 |
DM, % | 4.03% | 4.72% | 1.71% | 1.20% | 1.83% | 2.70% |
Age 40–49 | 4,879,816 | 4,956,005 | 5,064,587 | 5,202,444 | 5,341,530 | 5,088,876 |
DM in the subgroup, % | 2.14% | 2.30% | 2.45% | 2.59% | 2.70% | 2.44% |
No. of corneal grafts | 85 | 75 | 80 | 95 | 110 | 445 |
Incidence/100,000 person-yrs | 1.74 | 1.51 | 1.58 | 1.83 | 2.06 | 1.74 |
DM, % | 10.59% | 8.00% | 7.50% | 16.84% | 7.27% | 10.04% |
Age 50–59 | 5,536,118 | 5,406,320 | 5,245,352 | 5,089,290 | 4,928,276 | 5,241,071 |
DM in the subgroup, % | 6.87% | 7.16% | 7.38% | 7.57% | 7.68% | 7.33% |
No. of corneal grafts | 138 | 139 | 107 | 137 | 143 | 664 |
Incidence/100,000 person-yrs | 2.49 | 2.57 | 2.04 | 2.69 | 2.90 | 2.54 |
DM, % | 15.22% | 15.83% | 10.28% | 10.22% | 9.79% | 12.27% |
Age 60–69 | 4,409,809 | 4,642,821 | 4,888,294 | 5,024,702 | 5,127,315 | 4,818,588 |
DM in the subgroup, % | 15.53% | 16.20% | 16.76% | 17.15% | 17.34% | 16.60% |
No. of corneal grafts | 157 | 196 | 168 | 228 | 266 | 1015 |
Incidence/100,000 person-yrs | 3.56 | 4.22 | 3.44 | 4.54 | 5.19 | 4.19 |
DM, % | 35.67% | 26.02% | 36.31% | 25.88% | 24.06% | 29.59% |
Age 70+ | 3,882,950 | 3,904,960 | 3,914,660 | 4,030,514 | 4,166,277 | 3,979,872 |
DM in the subgroup, % | 21.41% | 22.88% | 24.15% | 25.27% | 26.17% | 23.98% |
No. of corneal grafts | 383 | 370 | 356 | 479 | 549 | 2137 |
Incidence/100,000 person-yrs | 9.86 | 9.48 | 9.09 | 11.88 | 13.18 | 10.70 |
DM, % | 31.85% | 32.16% | 35.39% | 33.19% | 30.24% | 32.57% |
All | 38,495,659 | 38,478,602 | 38,437,239 | 38,432,992 | 38,433,558 | 38,455,610 |
DM in the subgroup, % | 5.42% | 5.83% | 6.20% | 6.56% | 6.86% | 6.17% |
No. of corneal grafts | 914 | 919 | 845 | 1141 | 1250 | 5069 |
Incidence/100,000 person-yrs | 2.37 | 2.39 | 2.20 | 2.97 | 3.25 | 2.64 |
DM, % | 23.30% | 22.09% | 24.38% | 22.00% | 20.40% | 22.43% |
2013 | 2014 | 2015 | 2016 | 2017 | All | |
---|---|---|---|---|---|---|
Mean age ± SE | 60.99 ± 19.45 | 61 ± 18.8 | 61.25 ± 19.32 | 61.29 ± 20.04 | 63.15 ± 18.4 | 61.63 ± 19.2 |
Women (%) | 426 (49.71%) | 412 (47.96%) | 388 (49.87%) | 554 (52.31%) | 615 (53.15%) | 2395 (50.85%) |
Men (%) | 431 (50.29%) | 447 (52.04%) | 390 (50.13%) | 505 (47.69%) | 542 (46.85%) | 2315 (49.15%) |
Urban residence (%) | 612 (71.41%) | 600 (69.85%) | 550 (70.69%) | 740 (69.88%) | 792 (68.45%) | 3294 (69.94%) |
Rural Residence (%) | 245 (28.59%) | 259 (30.15%) | 228 (29.31%) | 319 (30.12%) | 365 (31.55%) | 1416 (30.06%) |
Indication | No. of Corneal Grafts 2013–2017 (% of all) | No. of Subjects with Corneal Grafts and Type 1 DM (% of All) | No. of Subjects with Corneal Grafts and Type 2 DM (% of All) | No. of Full-Thickness Corneal Grafts 2013–2017 (% of All) | No. of Partial-Corneal Grafts 2013–2017 (% of All) |
---|---|---|---|---|---|
Ocular surface disease | 1952 (38.51%) | 33 (41.77%) | 411 (39.18%) | 1707 (41.86%) | 245 (24.72%) |
Bullous keratopathy | 686 (13.53%) | 9 (11.39%) | 182 (17.35%) | 386 (9.47%) | 300 (30.27%) |
Infectious keratitis and corneal ulcers | 620 (12.23%) | 19 (24.05%) | 131 (12.49%) | 591 (14.49%) | 29 (2.93%) |
Keratoconus | 440 (8.68%) | 1 (1.27%) | 21 (2.00%) | 386 (9.47%) | 54 (5.45%) |
Leucoma and corneal scars | 260 (5.13%) | 3 (3.80%) | 53 (5.05%) | 242 (5.93%) | 18 (1.82%) |
Corneal pigmentations and deposits | 224 (4.42%) | 0 (0.00%) | 59 (5.62%) | 194 (4.76%) | 30 (3.03%) |
Corneal dystrophies incl. Fuchs’s dystrophy | 189 (3.73%) | 2 (2.53%) | 38 (3.62%) | 39 (0.96%) | 150 (15.14%) |
Band keratopathy | 124 (2.45%) | 2 (2.53%) | 26 (2.48%) | 80 (1.96%) | 44 (4.44%) |
Other | 574 (11.32%) | 10 (12.66%) | 128 (12.20%) | 453 (11.11%) | 121 (12.21%) |
All | 5069 (100%) | 79 (100%) | 1049 (100%) | 991 (100%) | 4078 (100%) |
2013 | 2014 | 2015 | 2016 | 2017 | All | |
---|---|---|---|---|---|---|
No. of full-thickness corneal grafts (%) | 201 (21.99%) | 182 (19.8%) | 156 (18.46%) | 223 (19.54%) | 229 (18.32%) | 991 (19.55%) |
No. of lamellar corneal grafts (%) | 713 (78.01%) | 737 (80.2%) | 689 (81.54%) | 918 (80.46%) | 1021 (81.68%) | 4078 (80.45%) |
No. of corneal grafts combined with cataract surgery (%) | 187 (20.46%) | 193 (21%) | 160 (18.93%) | 214 (18.76%) | 220 (17.6%) | 997 (19.39%) |
No. corneal grafts combined with glaucoma surgery (%) | 5 (0.55%) | 9 (0.98%) | 5 (0.59%) | 3 (0.26%) | 5 (0.4%) | 27 (0.52%) |
No. of corneal grafts combined with PPV (%) | 14 (1.53%) | 10 (1.09%) | 14 (1.66%) | 9 (0.79%) | 27 (2.16%) | 74 (1.44%) |
No. of corneal grafts in urgent admission (%) | 474 (51.86%) | 553 (60.17%) | 570 (67.46%) | 696 (61.00%) | 739 (59.12%) | 3032 (59.81%) |
OR | 95% CI | p-Value | |
---|---|---|---|
DM type (no) | reference | ||
Type 1 DM | 1.01 | (0.63; 1.64) | 0.976 |
Type 2 DM | 1.05 | (0.9; 1.23) | 0.498 |
Type—partial | reference | ||
Type—full | 11.54 | (10.08; 18.58) | 0.000 * |
Age 0–18 | reference | ||
Age 19–39 | 0.45 | (0.27; 0.72) | 0.001 * |
Age 40–49 | 0.49 | (0.29; 0.79) | 0.004 * |
Age 50–59 | 0.49 | (0.3; 0.78) | 0.004 * |
Age 60–69 | 0.44 | (0.27; 0.69) | 0.001 * |
Age 70+ | 0.35 | (0.21; 0.54) | 0.000 * |
Combined (no) | reference | ||
Combined (yes) | 0.82 | (0.70; 0.96) | 0.011 * |
Sex (man) | reference | ||
Sex (woman) | 1 | (0.88; 1.13) | 0.959 |
Residence (rural) | reference | ||
Residence (urban) | 0.91 | (0.8; 1.04) | 0.168 |
Comorbidity Variable | No. of People on the Waiting List | Comorbidity Variable | No. of People on the Waiting List |
---|---|---|---|
Age | 62.05 ± 19.00 | Fluid and electrolyte disorders | 176 (2.22%) |
Sex (women) | 4144 (52.30%) | AIDS/HIV | 0 (0.00%) |
Urban | 5466 (69.10%) | Hypothyroidism | 809 (10.21%) |
Alcohol abuse | 206 (2.60%) | Hypertension | 4770 (60.21%) |
Blood loss anaemia | 21 (0.27%) | Liver disease | 220 (2.78%) |
Arrhythmias | 1436 (18.13%) | Lymphoma | 42 (0.53%) |
Solid tumor without metastasis | 654 (8.26%) | Metastatic cancer | 53 (0.67%) |
Congestive heart failure | 1297 (16.37%) | Other neurological disorders | 352 (4.44%) |
Coagulopathy | 76 (0.96%) | Obesity | 210 (2.65%) |
Chronic pulmonary disease | 1241 (15.67%) | Paralysis | 69 (0.87%) |
Deficiency anaemia | 169 (2.13%) | Pulmonary circulation disorders | 81 (1.02%) |
Type 1 Diabetes | 104 (1.31%) | Psychoses | 91 (1.15%) |
Type 2 Diabetes | 1555 (19.63%) | Peptic ulcer disease excluding bleeding | 52 (0.66%) |
Depression | 613 (7.74%) | Peripheral vascular disorders | 1335 (16.85%) |
Drug abuse | 47 (0.59%) | Renal failure | 422 (5.33%) |
Fluid and electrolyte disorders | 176 (2.22%) | Rheumatoid arthritis/ collagen vascular diseases | 460 (5.81%) |
AIDS/HIV | 0 (0.00%) | Valvular disease | 356 (4.49%) |
Hypothyroidism | 809 (10.21%) | Weight loss | 45 (0.57%) |
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Kozioł, M.; Nowak, M.S.; Udziela, M.; Szaflik, J.P. The Association between Diabetes Mellitus and Keratoplasty in Poland in the Years 2013–2017. Int. J. Environ. Res. Public Health 2021, 18, 9767. https://doi.org/10.3390/ijerph18189767
Kozioł M, Nowak MS, Udziela M, Szaflik JP. The Association between Diabetes Mellitus and Keratoplasty in Poland in the Years 2013–2017. International Journal of Environmental Research and Public Health. 2021; 18(18):9767. https://doi.org/10.3390/ijerph18189767
Chicago/Turabian StyleKozioł, Milena, Michał Szymon Nowak, Monika Udziela, and Jacek Paweł Szaflik. 2021. "The Association between Diabetes Mellitus and Keratoplasty in Poland in the Years 2013–2017" International Journal of Environmental Research and Public Health 18, no. 18: 9767. https://doi.org/10.3390/ijerph18189767