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Diabetes increases risk for CAP
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Patients with diabetes are more likely to develop community-acquired pneumonia, experience longer hospital stays and have higher mortality rates than those without the disease, according to recent study findings.
“In line with studies that suggest that patients with [diabetes] are at higher risk for [community-acquired pneumonia], we observed that the [diabetes] prevalence in [community-acquired pneumonia] admissions between 2009 and 2012 was consistently higher, and more than double, when compared to the estimations of the [diabetes] prevalence in Portugal,” Madalena Martins, PhD, a postdoctoral researcher at the Chronic Diseases Research Center at Universidade Nova de Lisboa, Portugal, and colleagues wrote.
In a retrospective, nationwide register analysis, Martins and colleagues analyzed data from 74,175 adult patients with community-acquired pneumonia admitted to Portuguese hospitals between 2009 and 2012, using data from the National Hospital Discharge Database. Immunocompromised patients were excluded. Researchers looked for concomitant diagnoses of diabetes in discharge records and used nationwide diabetes statistics from the national diabetes prevalence study (PREVADIAB). Researchers compared rates of community-acquired pneumonia with and without concomitant diabetes and stratified by age, sex, hospitalization time and mortality rate, both across age groups and during the 2009 to 2012 period.
Within the cohort, 19,212 (25.9%) had diabetes. Researchers found that patients with community-acquired pneumonia and diabetes experienced a consistently longer hospital stay vs. patients with pneumonia without diabetes, with the difference in length of stay varying from 0.8 to 1 day, for an estimated increase of 15,370 days attributable to diabetes during the study period.
In-hospital mortality during the study period was higher in patients with community-acquired pneumonia and diabetes vs. patients (15.2%) with pneumonia without diabetes (13.5%), after adjustment for age and sex (P = .002). In addition, the diabetes burden in pneumonia episodes steadily increased over time, according to researchers, from 23.7% in 2009 to 28.1% in 2012. Researchers also found that pneumonia infections affected more men than women.
“Interestingly, the prevalence of diabetes among [community-acquired pneumonia] admissions was higher in women than in men (25.1% vs. 22.8%), as opposed to what is observed in the general population (10.2% vs. 14.6%), suggesting a higher risk of women with [diabetes] to develop [community-acquired pneumonia] infections,” the researchers wrote.
The researchers noted that patients with diabetes should be identified as a priority group for the adoption of general measures to prevent pneumonia, including smoking cessation and control of chronic illnesses, as well as influenza and prophylactic pneumococcal vaccination. – by Regina Schaffer
Disclosure: The study was supported by a Pfizer grant to the Ernesto Roma Foundation. The researchers report no relevant financial disclosures.
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