Table 2

Association between time to first DKA admission or death and patient-level and center-level characteristics among pediatric pump users in Ontario (n=3193)

DKA admission or death
Any DKA admission or death/100 person-years*Person-
years
Adjusted HR (95% CI)p Value
Patient characteristics
Age group
 <6th birthday (n=224)4.128980.88 (0.57 to 1.36)0.5569
 6th–13th birthday (n=1448)3.776046(Ref) 1.0
 ≥13th birthday (n=1521)3.3942232.35 (1.90 to 2.90)<0.0001
Sex
 Male (n=1634)3.475707(Ref) 1.0
 Female (n=1559)3.8654591.11 (0.88 to 1.41)0.3715
Duration of diabetes
 <5 years (n=1958)3.957168(Ref) 1.0
 ≥5 years (n=1235)3.1539990.76 (0.64 to 0.89)0.0007
Baseline HbA1c
 <7.5% (<58 mmol/mol) (n=718)2.372662(Ref) 1.0
 7.5–9.0% (58–75 mmol/mol) (n=1845)3.4365821.69 (1.31 to 2.18)<0.0001
 >9.0% (>75 mmol/mol) (n=630)6.2419232.63 (1.89 to 3.67)<0.0001
Deprivation quintile
 1 (least deprived) (n=1073)2.763798(Ref) 1.0
 2 (n=861)4.2929601.53 (1.22 to 1.91)0.0002
 3 (n=597)2.8421470.96 (0.67 to 1.36)0.8053
 4 (n=387)5.1313261.45 (1.07 to 1.95)0.0161
 5 (most deprived) (n=252)5.138571.58 (1.05 to 2.38)0.0272
 Missing (n=23)5.04791.87 (0.96 to 3.62)0.0654
Other chronic condition
 No (n=2616)3.728974(Ref) 1.0
 Yes (n=577)3.4221930.93 (0.71 to 1.22)0.6040
At least one DKA admission in 2 years prior to index date
 No (n=2802)3.309900(Ref) 1.0
 Yes (n=391)6.4812661.63 (1.28 to 2.07)<0.0001
Center characteristics
Center type
 Large community (n=1346)3.944669(Ref) 1.0
 Small community (n=642)5.8621851.22 (0.92 to 1.62)0.1609
 Tertiary (n=1205)2.2343130.92 (0.69 to 1.23)0.5820
24-hour support
 No (n=1730)4.245985(Ref) 1.0
 Yes (n=1463)2.9951820.90 (0.73 to 1.10)0.3023
Physician model
 Pediatric endocrinologist (n=1946)2.736948(Ref) 1.0
 Generalist (n=606)4.4920261.17 (0.83 to 1.66)0.3716
 Visiting pediatric endocrinologist (n=641)5.8421931.22 (0.90 to 1.66)0.2064
Annual nursing patient load
 <200 (n=1283)3.044665(Ref) 1.0
 ≥200 (n=1910)4.1165021.24 (1.00 to 1.52)0.0468
  • *Person-years is computed as the time from the date of initial application for pump funding to the earliest date of: admission for DKA or death, date of pump discontinuation, 19th birthday, or outmigration from Ontario.

  • DKA, diabetic ketoacidosis; HbA1c, glycated hemoglobin.