Table 2 Multivariate risk-adjustment of diabetes outcomes.

From: Risk-adjustment of diabetes health outcomes improves the accuracy of performance benchmarking

Population

Outcome

Model

Coef.

CI

p-value

aR2

T2DM

HbA1c

Female sex (refā€‰=ā€‰male)

0.29

(0.13, 0.44)

<0.001

0.044

Age (per 10 years)

āˆ’0.30

āˆ’0.36, āˆ’0.23)

<0.001

Duration (per 10 years)

0.22

(0.13, 0.31)

<0.001

Severity (refā€‰=ā€‰DSCI score 0)

Ā Ā Ā Ā DCSI score 1-2

0.41

(0.22, 0.60)

<0.001

Ā Ā Ā Ā DCSI score 3-4

0.34

(0.11, 0.56)

0.003

Ā Ā Ā Ā DCSI score ā‰„5

0.31

(0.05, 0.57)

0.019

Ever smoker (refā€‰=ā€‰never smoker)

0.21

(0.07, 0.36)

0.005

LDL-Ch

Fasting statusā€  (refā€‰=ā€‰non-fasting)

āˆ’0.01

(āˆ’0.15, 0.13)

0.914

0.078

Age (per 10 years)*

āˆ’0.13

(āˆ’0.17, āˆ’0.09)

<0.001

Duration (per 10 years)*

āˆ’0.08

(āˆ’0.13, āˆ’0.03)

0.002

Severity (ref = DSCI score 0)

Ā Ā Ā Ā DCSI score 1-2

āˆ’0.16

(āˆ’0.28, āˆ’0.05)

<0.001

Ā Ā Ā Ā DCSI score 3-4

āˆ’0.27

(āˆ’0.40, āˆ’0.13)

<0.001

Ā Ā Ā Ā DCSI score ā‰„5

āˆ’0.31

(āˆ’0.46, āˆ’0.15)

<0.001

SBP

Age (per 10 years)*

2.24

(1.68, 2.79)

<0.001

0.042

High BMI (ref = healthy BMI)

Ā Ā Ā Ā Overweight

2.85

(0.48, 5.52)

0.018

Ā Ā Ā Ā Obese

5.13

(2.88, 7.37)

<0.001

Ā Ā Ā Ā Morbidly obese

9.24

(6.63, 11.85)

<0.001

Severity (refā€‰=ā€‰DSCI score 0)

Ā Ā Ā Ā DCSI score 1-2

2.09

(0.45, 3.73)

0.012

Ā Ā Ā Ā DCSI score 3-4

3.02

(1.10, 4.94)

0.002

Ā Ā Ā Ā DCSI score ā‰„5

2.21

(0.01, 4.40)

0.048

T1DM

HbA1c

Age (per 10 years)*

āˆ’0.20

(āˆ’0.28, āˆ’0.12)

<0.001

0.048

Underweight (refā€‰=ā€‰healthy BMI)

1.73

(0.91, 2.55)

<0.001

Severity (refā€‰=ā€‰DSCI score 0)

Ā Ā Ā Ā DCSI score 1-2

0.33

(0.03, 0.62)

0.032

Ā Ā Ā Ā DCSI score 3-4

0.21

(āˆ’0.23, 0.65)

0.344

Ā Ā Ā Ā DCSI score ā‰„5

0.61

(0.14, 1.08)

0.010

Ever smoker (refā€‰=ā€‰never smoker)

0.33

(0.08, 0.59)

0.011

LDL-Ch

Fasting statusā€  (refā€‰=ā€‰non-fasting)

āˆ’0.08

(āˆ’0.27, 0.12)

0.442

0.051

Duration (per 10 years)*

āˆ’0.14

(āˆ’0.19, āˆ’0.09)

<0.001

SBP

Male sex (refā€‰=ā€‰female)

6.06

(3.99, 8.12)

<0.001

0.210

Age (per 10 years)*

2.51

(1.70, 3.31)

<0.001

High BMI (refā€‰=ā€‰healthy BMI)

Ā Ā Ā Ā Overweight

1.65

(āˆ’0.73, 4.04)

0.173

Ā Ā Ā Ā Obese

6.42

(3.76, 9.07)

<0.001

Ā Ā Ā Ā Morbidly obese

7.28

(1.03, 13.54)

0.023

Duration (per 10 years)*

2.01

(1.08, 2.94)

<0.001

Population

Outcome

Model

OR

CIs

p-value

ROC

T2DM

Severe hypo

Duration (per 10 years)*

1.54

(1.27, 1.86)

<0.001

0.613

T1DM

Severe hypo

Duration (per 10 years)*

1.39

(1.23, 1.58)

<0.001

0.678

High BMI (refā€‰=ā€‰healthy BMI)

Ā Ā Ā Ā Overweight

0.84

(0.54, 1.31)

0.446

Ā Ā Ā Ā Obese

0.47

(0.27, 0.83)

0.009

Ā Ā Ā Ā Morbidly obese

0.39

(0.08, 1.75)

0.217

Ever smoker (refā€‰=ā€‰never smoker)

1.96

(1.33, 2.89)

0.001

  1. Abbreviations: aR2ā€‰=ā€‰adjusted R2, CIā€‰=ā€‰confidence interval, Coef.ā€‰=ā€‰coefficient, DCSIā€‰=ā€‰diabetes complications severity index, HbA1cā€‰=ā€‰glycated haemoglobin (%), hypoā€‰=ā€‰hypoglycaemia (ā‰„ā€‰1 episodes in previous 12 months), LDL-Chā€‰=ā€‰low density lipoprotein cholesterol (mmol/L), ORā€‰=ā€‰odds ratio, ROCā€‰=ā€‰receiver operator characteristic (area under curve), SBPā€‰=ā€‰systolic blood pressure (mmHg), T1DMā€‰=ā€‰type 1 diabetes mellitus, T2DMā€‰=ā€‰type 2 diabetes mellitus.
  2. *Coefficient calculated for age/duration (per 10 years) indicates average change in outcome associated with a 10-year increase in age/duration.
  3. ā€ Fasting status was fixed into the multivariate risk model based on a priori clinical reasoning.
Back to article page