Dysglycaemia and 90 day and 1 year risks of death or readmission in patients hospitalised for community-acquired pneumonia

Abstract

Aims/hypothesis: The aim of this study was to investigate whether dysglycaemia at admission is associated with adverse events at 90 days or 1 year in a population-based cohort of patients hospitalised with community-acquired pneumonia (CAP).

Methods: Clinical and laboratory data were prospectively collected on all 2,366 adults without diabetes admitted with CAP to six hospitals in Edmonton (AB, Canada) and grouped according to admission glucose: 4.0 to <6.1 mmol/l(n=778, reference group), 6.1 to <7.8 mmol/l (n=924); 7.8 to<11.1 mmol/l (n=535); and 11.1 to 20 mmol/l (n=129). Multivariable Cox models were used to examine the relationship between dysglycaemia and mortality or CAP readmission during follow-up.

Results: The mean age was 69 (SD 18) years and 48% of participants were female. Compared with those with glucose <6.1 mmol/l (114 [15%] deaths), no differences in 90 day mortality were observed in the dysglycaemia groups: 143 deaths (15%) in the 6.1-7.8 mmol/l group (adjusted HR [aHR] 0.92, 95% CI 0.72-1.18), 111 deaths (21%) in the 7.8-11.1 mmol/l group (aHR 1.05, 0.81-1.37)and 34 deaths (26%) in the 11.1-20 mmol/l group (aHR 1.30, 0.88-1.93). Similarly, compared with those in the <6.1 mmol/l group (198 [25%] deaths), no difference in 1 year mortality was observed: 233 deaths (25%) in the 6.1 to <7.8 mmol/l group (aHR 0.86, 0.71-1.04), 164 deaths (31%) in the 7.8 to <11.1 mmol/l group (aHR 0.92, 0.75-1.14) and 49 deaths (38%) in the 11.1 to 20 mmol/l group (aHR 1.12, 0.81-1.55). Readmissions for CAP were also similar at 1 year: compared with 10% (70/707) in the 6.1 mmol/l group, the frequencies were 8% (66/842), 9% (45/474) and 10% (11/107) in the 6.1 to <7.8 mmol/l, 7.8 to <11.1 mmol/l, and 11.1 to 20 mmol/l groups, respectively (p>0.05 for all comparisons).

Conclusions/interpretation: Although previously associated with inpatient morbidity and mortality, admission dysglycaemia was not associated with an increased risk of death or CAP readmission at 90 days or 1 year among those who survived hospitalisation for pneumonia.