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BMJ Open Diabetes Res Care. 2016 May 20;4(1):e000181. doi: 10.1136/bmjdrc-2015-000181. eCollection 2016.

Diabetes hinders community-acquired pneumonia outcomes in hospitalized patients.

Author information

1
APDP-Diabetes Portugal (Education and Research Centre/APDP-ERC), Lisboa, Portugal; Chronic Diseases Research Center (CEDOC), NOVA Medical School-FCM, Universidade Nova de Lisboa, Lisboa, Portugal; Instituto Gulbenkian de Ciência, Oeiras, Portugal.
2
APDP-Diabetes Portugal (Education and Research Centre/APDP-ERC) , Lisboa , Portugal.
3
APDP-Diabetes Portugal (Education and Research Centre/APDP-ERC), Lisboa, Portugal; Chronic Diseases Research Center (CEDOC), NOVA Medical School-FCM, Universidade Nova de Lisboa, Lisboa, Portugal.
4
Service of Pneumology , Hospital Pulido Valente, Centro Hospitalar Lisboa Norte , Lisboa , Portugal.
5
Department of Epidemiology , Instituto Nacional de Saúde Dr. Ricardo Jorge , Lisboa , Portugal.
6
Instituto Gulbenkian de Ciência , Oeiras , Portugal.

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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