High Risk of Deep Neck Infection in Patients with Type 1 Diabetes Mellitus: A Nationwide Population-Based Cohort Study
Geng-He Chang 1,2,3,†, Meng-Chang Ding 1,†, Yao-Hsu Yang 2,4,5, Yung-Hsiang Lin 6, Chia-Yen Liu 2, Meng-Hung Lin 2
, Ching-Yuan Wu 4,5, Cheng-Ming Hsu 1,5 and Ming-Shao Tsai 1,2,3,*
, Ching-Yuan Wu 4,5, Cheng-Ming Hsu 1,5 and Ming-Shao Tsai 1,2,3,*
1
Department of Otolaryngology, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
2
Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
3
Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
4
Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
5
School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
6
Division of Endocrinology and Metabolism, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
*
Author to whom correspondence should be addressed.
†
The author contributed equally to this work.
J. Clin. Med. 2018, 7(11), 385; https://doi.org/10.3390/jcm7110385
Received: 30 September 2018 / Revised: 20 October 2018 / Accepted: 23 October 2018 / Published: 25 October 2018
(This article belongs to the Special Issue Head and Neck Critical Illness: Basic and Clinical Research Implications)
Abstract
Objective: To investigate the risk of deep neck infection (DNI) in patients with type 1 diabetes mellitus (T1DM). Methods: The database of the Registry for Catastrophic Illness Patients, affiliated to the Taiwan National Health Insurance Research Database, was used to conduct a retrospective cohort study. In total, 5741 patients with T1DM and 22,964 matched patients without diabetes mellitus (DM) were enrolled between 2000 and 2010. The patients were followed up until death or the end of the study period (31 December 2013). The primary outcome was the occurrence of DNI. Results: Patients with T1DM exhibited a significantly higher cumulative incidence of DNI than did those without DM (p < 0.001). The Cox proportional hazards model showed that T1DM was significantly associated with a higher incidence of DNI (adjusted hazard ratio, 10.71; 95% confidence interval, 6.02–19.05; p < 0.001). The sensitivity test and subgroup analysis revealed a stable effect of T1DM on DNI risk. The therapeutic methods (surgical or nonsurgical) did not differ significantly between the T1DM and non-DM cohorts. Patients with T1DM required significantly longer hospitalization for DNI than did those without DM (9.0 ± 6.2 vs. 4.1 ± 2.0 days, p < 0.001). Furthermore, the patients with T1DM were predisposed to DNI at a younger age than were those without DM. Conclusions: T1DM is an independent risk factor for DNI and is associated with a 10-fold increase in DNI risk. The patients with T1DM require longer hospitalizations for DNI and are younger than those without DM. View Full-TextKeywords:
cervical; cellulitis; abscess; deep neck infection; diabetes mellitus
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Chang, G.-H.; Ding, M.-C.; Yang, Y.-H.; Lin, Y.-H.; Liu, C.-Y.; Lin, M.-H.; Wu, C.-Y.; Hsu, C.-M.; Tsai, M.-S. High Risk of Deep Neck Infection in Patients with Type 1 Diabetes Mellitus: A Nationwide Population-Based Cohort Study. J. Clin. Med. 2018, 7, 385.
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