Derivation and external validation of risk algorithms for cerebrovascular (re)hospitalisation in patients with type 2 diabetes: Two cohorts study.
Diabetes Res Clin Pract
; 144: 74-81, 2018 Oct.
Article
em En
| MEDLINE
| ID: mdl-30114459
ABSTRACT
AIMS:
Cerebrovascular disease is one of more typical reasons for hospitalisation and re-hospitalisation in people with type 2 diabetes. We aimed to derive and externally validate two risk prediction algorithms for cerebrovascular hospitalisation and re-hospitalisation.METHODS:
Two independent cohorts were used to derive and externally validate the two risk scores. The development cohort comprises 4704 patients with type 2 diabetes registered in 18 general practices across Cambridgeshire. The validation cohort includes 1121 type 2 patients from a post-trial cohort data. Outcomes were cerebrovascular hospitalisation within two years and cerebrovascular re-hospitalisation within ninety days of the previous cerebrovascular hospitalisation. Logistic regression was applied to derive the two risk scores for cerebrovascular hospitalisation and re-hospitalisation from development cohort, which were externally validated in the validation cohort.RESULTS:
The incidence of cerebrovascular hospitalisation and re-hospitalisation was 3.76% and 1.46% in the development cohort, and 4.99% and 1.87% in the external validation cohort. Age, gender, body mass index, blood pressures, and lipid profiles were included in the final model. Model discrimination was similar in both cohorts, with all C-statisticsâ¯>â¯0.70, and very good calibration of observed and predicted individual risks.CONCLUSION:
Two new risk scores that quantify individual risks of cerebrovascular hospitalisation and re-hospitalisation have been well derived and externally validated. Both scores are on the basis of a few of clinical measurements that are commonly available for patients with type 2 diabetes in primary care settings and could work as tools to identify individuals at high risk of cerebrovascular hospitalisation and re-hospitalisation.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Admissão do Paciente
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Readmissão do Paciente
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Algoritmos
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Transtornos Cerebrovasculares
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Diabetes Mellitus Tipo 2
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Hospitalização
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Reino Unido