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. 2016 May 20;4(1):e000181.
doi: 10.1136/bmjdrc-2015-000181. eCollection 2016.

Diabetes hinders community-acquired pneumonia outcomes in hospitalized patients

M Martins  1 , J M Boavida  2 , J F Raposo  3 , F Froes  4 , B Nunes  5 , R T Ribeiro  3 , M P Macedo  3 , C Penha-Gonçalves  6
Affiliations

Diabetes hinders community-acquired pneumonia outcomes in hospitalized patients

M Martins et al. BMJ Open Diabetes Res Care. .

Abstract

Objectives: This study aimed to estimate the prevalence of diabetes mellitus (DM) in hospitalized patients with community-acquired pneumonia (CAP) and its impact on hospital length of stay and in-hospital mortality.

Research design and methods: We carried out a retrospective, nationwide register analysis of CAP in adult patients admitted to Portuguese hospitals between 2009 and 2012. Anonymous data from 157 291 adult patients with CAP were extracted from the National Hospital Discharge Database and we performed a DM-conditioned analysis stratified by age, sex and year of hospitalization.

Results: The 74 175 CAP episodes that matched the inclusion criteria showed a high burden of DM that tended to increase over time, from 23.7% in 2009 to 28.1% in 2012. Interestingly, patients with CAP had high DM prevalence in the context of the national DM prevalence. Episodes of CAP in patients with DM had on average 0.8 days longer hospital stay as compared to patients without DM (p<0.0001), totaling a surplus of 15 370 days of stay attributable to DM in 19 212 admissions. In-hospital mortality was also significantly higher in patients with CAP who have DM (15.2%) versus those who have DM (13.5%) (p=0.002).

Conclusions: Our analysis revealed that DM prevalence was significantly increased within CAP hospital admissions, reinforcing other studies' findings that suggest that DM is a risk factor for CAP. Since patients with CAP who have DM have longer hospitalization time and higher mortality rates, these results hold informative value for patient guidance and healthcare strategies.

Keywords: Adult Diabetes; Community Health; Risk Factors.

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Figures

Figure 1
Figure 1
Age distribution of CAP with diabetes and CAP without diabetes (2009 to 2012) shows a stronger skewedness to old ages in patients with CAP-DM. CAP, community-acquired pneumonia; CAP-DM, DM in CAP; DM, diabetes mellitus.
Figure 2
Figure 2
Diabetes prevalence in CAP admissions and the general Portuguese population from 2009 to 2012. Diabetes prevalence in CAP admissions consistently progressed from 2009 to 2012, as compared to the general Portuguese population, in the age range 20–79 years. CAP, community-acquired pneumonia.
Figure 3
Figure 3
Gender differences in diabetes prevalence in 2009 in the general Portuguese population patients and in patients with CAP. Diabetes prevalence is higher in women as compare to men in CAP admissions but not in the general Portuguese population.
See this image and copyright information in PMC

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