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) | 4.12 | 898 | 0.88 (0.57 to 1.36) | 0.5569 |
6th–13th birthday (n=1448) | 3.77 | 6046 | (Ref) 1.0 | |
≥13th birthday (n=1521) | 3.39 | 4223 | 2.35 (1.90 to 2.90) | <0.0001 |
Sex | ||||
Male (n=1634) | 3.47 | 5707 | (Ref) 1.0 | |
Female (n=1559) | 3.86 | 5459 | 1.11 (0.88 to 1.41) | 0.3715 |
Duration of diabetes | ||||
<5 years (n=1958) | 3.95 | 7168 | (Ref) 1.0 | |
≥5 years (n=1235) | 3.15 | 3999 | 0.76 (0.64 to 0.89) | 0.0007 |
Baseline HbA1c | ||||
<7.5% (<58 mmol/mol) (n=718) | 2.37 | 2662 | (Ref) 1.0 | |
7.5–9.0% (58–75 mmol/mol) (n=1845) | 3.43 | 6582 | 1.69 (1.31 to 2.18) | <0.0001 |
>9.0% (>75 mmol/mol) (n=630) | 6.24 | 1923 | 2.63 (1.89 to 3.67) | <0.0001 |
Deprivation quintile | ||||
1 (least deprived) (n=1073) | 2.76 | 3798 | (Ref) 1.0 | |
2 (n=861) | 4.29 | 2960 | 1.53 (1.22 to 1.91) | 0.0002 |
3 (n=597) | 2.84 | 2147 | 0.96 (0.67 to 1.36) | 0.8053 |
4 (n=387) | 5.13 | 1326 | 1.45 (1.07 to 1.95) | 0.0161 |
5 (most deprived) (n=252) | 5.13 | 857 | 1.58 (1.05 to 2.38) | 0.0272 |
Missing (n=23) | 5.04 | 79 | 1.87 (0.96 to 3.62) | 0.0654 |
Other chronic condition | ||||
No (n=2616) | 3.72 | 8974 | (Ref) 1.0 | |
Yes (n=577) | 3.42 | 2193 | 0.93 (0.71 to 1.22) | 0.6040 |
At least one DKA admission in 2 years prior to index date | ||||
No (n=2802) | 3.30 | 9900 | (Ref) 1.0 | |
Yes (n=391) | 6.48 | 1266 | 1.63 (1.28 to 2.07) | <0.0001 |
Center characteristics | ||||
Center type | ||||
Large community (n=1346) | 3.94 | 4669 | (Ref) 1.0 | |
Small community (n=642) | 5.86 | 2185 | 1.22 (0.92 to 1.62) | 0.1609 |
Tertiary (n=1205) | 2.23 | 4313 | 0.92 (0.69 to 1.23) | 0.5820 |
24-hour support | ||||
No (n=1730) | 4.24 | 5985 | (Ref) 1.0 | |
Yes (n=1463) | 2.99 | 5182 | 0.90 (0.73 to 1.10) | 0.3023 |
Physician model | ||||
Pediatric endocrinologist (n=1946) | 2.73 | 6948 | (Ref) 1.0 | |
Generalist (n=606) | 4.49 | 2026 | 1.17 (0.83 to 1.66) | 0.3716 |
Visiting pediatric endocrinologist (n=641) | 5.84 | 2193 | 1.22 (0.90 to 1.66) | 0.2064 |
Annual nursing patient load | ||||
<200 (n=1283) | 3.04 | 4665 | (Ref) 1.0 | |
≥200 (n=1910) | 4.11 | 6502 | 1.24 (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.