Long-term quality-of-care score for predicting the occurrence of acute myocardial infarction in patients with type 2 diabetes mellitus

作     者：Pi-I Li How-Ran Guo 

作者机构：Department of Family MedicineChi Mei Medical CenterTainan 710TaiwanChina Department of PharmacyChia Nan University of Pharmacy and ScienceTainan 717TaiwanChina Department of Environmental and Occupational HealthCollege of MedicineNational Cheng Kung UniversityTainan 704TaiwanChina Department of Occupational and Environmental MedicineNational Cheng Kung University HospitalTainan 704TaiwanChina 

出 版 物：《World Journal of Diabetes》 (世界糖尿病杂志（英文版）（电子版）)

年 卷 期：2023年第14卷第7期

页      面：1091-1102页

核心收录：

学科分类：1011[医学-护理学（可授医学、理学学位）] 10[医学] 

基　　金：Supported by the Chi-Mei Medical Center No.CMNCKU10214 and No.CMFHR112027 

主　　题：Acute myocardial infarction Cardiovascular disease Diabetes mellitus Quality-of-care Score 

摘      要：BACKGROUND Cardiovascular disease(CVD)is the leading cause of death globally,and diabetes mellitus(DM)is a well-established risk *** the risk factors for CVD,DM is a major modifiable *** the fatal CVD outcomes,acute myocardial infarction(AMI)is the most common cause of *** To develop a long-term quality-of-care score for predicting the occurrence of AMI among patients with type 2 DM on the basis of the hypothesis that good quality of care can reduce the risk of AMI in patients with *** Using Taiwan’s Longitudinal Cohort of Diabetes Patients Database and the medical charts of a medical center,we identified incident patients diagnosed with type 2 DM from 1999 to 2003 and followed them until *** constructed a summary quality-of-care score(with values ranging from 0 to 8)with process indicators(frequencies of HbA1c and lipid profile testing and urine,foot and retinal examinations),intermediate outcome indicators(low-density lipoprotein,blood pressure and HbA1c),and co-morbidity of *** associations between the score and the incidence of AMI were evaluated using Cox regression *** A total of 7351 patients who had sufficient information to calculate the score were *** comparison with participants who had scores≤1,those with scores between 2 and 4 had a lower risk of developing AMI[adjusted hazard ratio(AHR)=0.71;95% confidence interval(95%CI):0.55-0.90],and those with scores≥5 had an even lower risk(AHR=0.37;95%CI:0.21-0.66).CONCLUSION Good quality of care can reduce the risk of AMI in patients with type 2 *** quality-of-care score developed in this study had a significant association with the risk of AMI and thus can be applied to guiding the care for these patients.