Clinical Outcomes of Community-Acquired Pneumonia in Patients with Diabetes Mellitus

Authors

Siddartha Bandhary, Providence Hospital, Washington, DCFollow
Bolivar Y. Contreras-Mora, Providence Hospital, Washington, DCFollow
Ruby Gupta, Providence Hospital, Washington, DCFollow
Patricia Fernandez, Instituto Nacional del Tórax, Santiago, ChileFollow
Patricio Jimenez, Universidad Austral de Chile, Valdivia, ChileFollow
Paula Peyrani, University of Louisville, Louisville, KYFollow
Timothy L. Wiemken, University of Louisville, Louisville, KYFollow
Steven Burdette, Wright State University Boonshoft School of MedicineFollow
Julio A. Ramirez, University of Louisville, Louisville, KYFollow
Hadi Harati, Stanford University, Stanford, CAFollow
Jose Bordon, Providence Hospital, Washington, DCFollow

Abstract

Background: Studies have found admission hyperglycemia as a predictor of poor outcomes in Community acquired Pneumonia (CAP), whereas others have not. The objective of this study was to evaluate the impact of diabetes mellitus (DM) on mortality as well as Length of stay (LOS) and Time to clinical stability (TCS) of hospitalized patients with CAP.

Materials and Methods: Adult patients hospitalized with CAP enrolled at Community-Acquired Pneumonia Organization (CAPO) database with DM were categorized as admission blood glucose ≥ 250 mg/dL (diabetes mellitus blood sugar (BG) > 250) and admission blood glucose ≤ 250 mg/dL (DM BG ≤ 250). CAP outcomes included: all-cause in-hospital mortality, all-cause 28-day mortality, length of stay (LOS) and time to clinical stability (TCS).

Results: From a total of 7,303 patients with CAP, 294 (17.7%) had DM; out of whom 960 (13.1%) patients had BG ≤ 250 mg/dL, and 334 (4.6%) patients had BG > 250 mg/dL. The in-hospital mortality was 9.3% for controls, 9.9% for the DM BG ≤ 250 mg/dL group and 13.4% for DM BG > 250 mg/dL group (p = 0.04). Patients with DM BG > 250 mg/dL compared to the control group had a higher risk of in-hospital mortality (Hazard ratio (RR) = 1.32, 95% CI: 1.02-1.72, p = 0.034) and 28-day mortality (RR = 1.31, 95% CI: 1.01-1.71, p = 0.048). Patients in the DM BG ≤ 250 mg/dL group compared to the control group did not have a greater risk for in-hospital mortality (RR = 1.23, 95% CI: 0.16-8.09, p = 0.237), 28-day mortality (RR = 1.09, 95% CI: 0.90-1.32, p = 0.398), LOS (HR = 0.93, 95% CI: 0.85-1.02, p = 0.130), or TCS (HR = 0.95, 95% CI: 0.87-1.05, p = 0.320).

Conclusions: DM patients with BG > 250 mg/dL were associated with increased in-hospital mortality and 28-day mortality. Further studies are needed to link the role of hyperglycemia to CAP outcome.

DOI

10.18297/jri/vol1/iss1/5

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.

Recommended Citation

Bandhary, Siddartha; Contreras-Mora, Bolivar Y.; Gupta, Ruby; Fernandez, Patricia; Jimenez, Patricio; Peyrani, Paula; Wiemken, Timothy L.; Burdette, Steven; Ramirez, Julio A.; Harati, Hadi; and Bordon, Jose (2017) "Clinical Outcomes of Community-Acquired Pneumonia in Patients with Diabetes Mellitus," The University of Louisville Journal of Respiratory Infections: Vol. 1 : Iss. 1 , Article 5.
DOI: https://doi.org/10.18297/jri/vol1/iss1/5
Available at: https://ir.library.louisville.edu/jri/vol1/iss1/5