May 24, 2018
Researchers investigated the potential impact that diabetes may have on patients hospitalized with community-acquired pneumonia and presented their findings at the 2018 European Congress of Endocrinology annual meeting (abstract GP77).
According to Jubbin Jacob, MD, DNB, MNAMS, (Christian Medical College and Hospital, Ludhiana, India), “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” (May 23, 2018. Endocrine Today).
Dr Jacob and his colleagues conducted a cross-sectional analysis, analyzing data from 175 patients admitted with community-acquired pneumonia to a tertiary care hospital: 49 with diabetes (mean age, 64 years) and 126 without diabetes (mean age, 58 years).
Regression analysis was used to find risk factors for mortality due to pneumonia in patients with and without diabetes. They also employed multivariate analysis to isolate the effect of diabetes on mortality in pneumonia while controlling the effect of other variables (they excluded proven H1N1 cases).
Of the patients with diabetes, 79.59% had other comorbidities; of note, 53.06% had heart disease. 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.
Base on the findings from the multivariate analysis, diabetes was shown to be an independent predictor of mortality—results persisted after adjusting for age, chronic obstructive pulmonary disease statues, 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).
Dr Jacob said, “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.” However, further research would be needed to investigate this.
—Amanda Del Signore
For more Annals of Long-Term Care articles, visit the homepage
To view the Annals of Long-Term Care print issue, click here