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Diabetes may predict mortality in inpatient community-acquired pneumonia
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Among patients hospitalized with community-acquired pneumonia, diabetes is an independent predictor of mortality after controlling for age, other respiratory diseases and H1N1 infection, according to study findings presented at the European Congress of Endocrinology annual meeting.
“Patients with type 2 diabetes who develop community-acquired pneumonia severe enough to warrant admission into a hospital are three times more likely to die compared to patients without diabetes,” Jubbin Jacob, MD, DNB, MNAMS, of the endocrine and diabetes unit of Christian Medical College and Hospital in Ludhiana, India, told Endocrine Today. “A percentage of community acquired pneumonia is vaccine preventable. Improvement in the uptake of these vaccines among patients with diabetes might to some extent improve outcomes in patients with type 2 diabetes.”
In a cross-sectional analysis, Jacob and colleagues analyzed data from 175 patients, including 49 with diabetes (mean age, 64 years) and 126 without diabetes (mean age, 58 years), admitted with community-acquired pneumonia to a tertiary care hospital. They used regression analysis to find the risk factors for mortality due to pneumonia in patients with and without diabetes. Multivariate analysis was also used to isolate the effect of diabetes for mortality in pneumonia (after excluding proven H1N1 cases) while controlling the effect of other variables.
Among patients with diabetes, 79.59% had other comorbidities, including 53.06% with heart disease. Researchers found that increased blood glucose level, higher pneumonia severity score, smoking status, presence of respiratory failure, metabolic acidosis and requirement of ventilation were associated with increased risk for mortality in patients with diabetes.
In multivariate analysis, diabetes was an independent predictor of mortality, with results persisting after adjusting for age, chronic obstructive pulmonary disease status and H1N1 infection (adjusted OR = 2.344; 95% CI, 1.02-5.382). Diabetes was also an independent predictor for mortality in community-acquired pneumonia (after excluding H1N1) with an adjusted OR of 3.439 (95% CI, 1.382-8.559).
“Research is still needed to establish that outcomes actually improve once adult vaccination against respiratory illness is universal among patients with diabetes,” Jacob said. – by Regina Schaffer
Reference:
Joy E, et al. Abstract GP77. Presented at: European Congress of Endocrinology; May 19-22, 2018; Barcelona, Spain.
Disclosure: Jacob reports no relevant financial disclosures.