Background: Community acquired pneumonia (CAP) is a common condition and a major cause of morbidity. Diabetes mellitus (DM) increases the risk and complications of infectious diseases. However, it is necessary to clarify if DM and glycemia at the time of presentation are prognostic factors in patients with CAP.
Objectives: To evaluate the relationship between DM/glycemia at the time of presentation and complications, length of stay and mortality in patients with CAP, and the relationship between glycemic control and complications in diabetics.
Methods: Observational, analytical, and retrospective study of adults admitted to our Hospital between October/2011 and March/2012, with CAP. Electronic clinical data were analyzed and telephone calls were done to assess mortality at 30 and 90 days. The χ2, MannWhitney, KruskalWallis tests and logistic regression were used.
Results: Of the 440 included patients, 51.1% were women, 83.1% elderly and 29.3% had a prior diagnosis of DM. Of these, 48.8% had HbA1c measured (median 6.8%, 25th percentile: 6.3%, and 75th percentile: 7.8%). The median glucose was 134 mg/dl (P25: 111 mg/dl and P75: 176 mg/dl). It was shown that patients with DM were older (P=0.002), had higher severity of pneumonia, assessed by CRB-65 (P=0.025), more complications (P=0.001), and longer length of stay (P=0.001). DM proved to be a predictor of complications (P=0.008). There was no association between DM and mortality, nor between HbA1c levels and complications, length of stay and mortality. Moreover, it was verified a gradual increase of days of stay for higher glucose levels at admission (P=0.016) and a trend towards complications in patients with hyperglycemia. However, there were no statistically significant differences between glucose levels and mortality.
Conclusion: DM and hyperglycemia on admission are associated with adverse outcome in CAP. Both are associated with prolongation of stay and DM predicts complications from CAP.
27 Apr - 01 May 2013
European Society of Endocrinology