Volume 45 Issue 2
Feb.  2024
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Jianfang MA, Xiaoling HUANG, Yanhua LI, Di MA, Kaifen YUAN. Analysis of Clinical Characteristics and Death Risk Factors in Patients with Community-acquired Pneumonia Complicated with Diabetes[J]. Journal of Kunming Medical University, 2024, 45(2): 123-130. doi: 10.12259/j.issn.2095-610X.S20240217
Citation: Jianfang MA, Xiaoling HUANG, Yanhua LI, Di MA, Kaifen YUAN. Analysis of Clinical Characteristics and Death Risk Factors in Patients with Community-acquired Pneumonia Complicated with Diabetes[J]. Journal of Kunming Medical University, 2024, 45(2): 123-130. doi: 10.12259/j.issn.2095-610X.S20240217

Analysis of Clinical Characteristics and Death Risk Factors in Patients with Community-acquired Pneumonia Complicated with Diabetes

doi: 10.12259/j.issn.2095-610X.S20240217
  • Received Date: 2023-10-10
    Available Online: 2024-02-22
  • Publish Date: 2024-02-25
  •   Objective   To explore the clinical characteristics and risk factors of death during hospitalization in patients with community-acquired pneumonia(CAP) complicated with diabetes mellitus(DM).   Methods   A retrospective analysis was performed on 566 patients with CAP hospitalized in the Second Affiliated Hospital of Kunming Medical University from January 2018 to January 2022. The patients were divided into simple CAP group(n=478) and CAP combined with diabetes(CAP+DM) group(n=88) according to whether they had diabetes, and then CAP+DM group(n=88) was divided into survival group(n=69) and death group(n =19) according to whether the patients died during hospitalization. The clinical data and laboratory test indicators of patients in different groups were compared. Cox regression analysis was used to screen the risk factors of death during hospitalization in the CAP+DM group. Receiver operating characteristic(ROC) curve was plotted to evaluate the predictive value of independent risk factors on hospitalization death.   Results   Compared with the simple CAP group, the CAP+DM group had significant differences in age, concomitant hypertension, coronary heart disease, CURB-65 score, neutrophil to lymphocyte ratio(NLR), C-reactive protein(CRP), procalcitonin(PCT), albumin(ALB), prealbumin(PA), glucose(GLU), serum potassium(K), calcium(Ca), phosphorus(P), magnesium(Mg), lactic acid(Lac), non-invasive ventilation time, ICU occupancy rate and mortality rate(P < 0.05); Compared with the survival group, there were statistically significant differences in CURB-65 score, NLR, CRP, PCT, GIU, ALB, PA, serum iron(Fe), Ca, non-invasive ventilation time, and ICU admission rate among the death group patients(P < 0.05). Cox regression analysis showed that the increase of NLR level and the decrease in PA level were the risk factors for in-hospital death in patients with CAP complicated with diabetes(P < 0.05). When the PA cutoff value was 91 mg/L, the AUC, sensitivity, and specificity for predicting in-hospital death of CAP patients with diabetes were 0.849, 84.2% and 81.2%, respectively.   Conclusion   Patients with CAP combined with diabetes are more serious and have worse prognosis than those with CAP alone. PA has a good predictive value for the prognosis of these patients. Early detection and active intervention should be carried out to reduce the in-hospital mortality of patients.
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  • [1]
    Sun Y,Li H,Pei Z,et al. Incidence of community-acquired pneumonia in urban China: A national population-based study[J]. Vaccine,2020,38(52):8362-8370. doi: 10.1016/j.vaccine.2020.11.004
    [2]
    Aliberti S,Dela C S,Amati F,et al. Community-acquired pneumonia[J]. Lancet,2021,398(10303):906-919. doi: 10.1016/S0140-6736(21)00630-9
    [3]
    Baker E H,Baines D L. Airway glucose homeostasis[J]. Chest,2018,153(2):507-514. doi: 10.1016/j.chest.2017.05.031
    [4]
    Zeng W,Huang X,Luo W,et al. Association of admission blood glucose level and clinical outcomes in elderly community‐acquired pneumonia patients with or without diabetes[J]. The Clinical Respiratory Journal,2022,16(8):562-571. doi: 10.1111/crj.13526
    [5]
    Klein O L,Krishnan J A,Glick S,et al. Systematic review of the association between lung function and Type 2 diabetes mellitus[J]. Diabetic Medicine,2010,27(9):977-987. doi: 10.1111/j.1464-5491.2010.03073.x
    [6]
    中华医学会呼吸病学分会. 中国成人社区获得性肺炎诊断和治疗指南(2016年版)[J]. 中华结核和呼吸杂志,2016,39(4):253-279. doi: 10.3760/cma.j.issn.1001-0939.2016.04.005
    [7]
    陈亮,韩秀迪,李艳丽,等. 糖尿病合并社区获得性肺炎住院患者临床特征和死亡危险因素分析[J]. 中国糖尿病杂志,2021,29(1):14-19. doi: 10.3969/j.issn.1006-6187.2021.01.004
    [8]
    邓伟吾. 糖尿病的肺功能损害和肺部并发症[J]. 临床肺科杂志,2010,15(7):903-905. doi: 10.3969/j.issn.1009-6663.2010.07.001
    [9]
    Di Y S,Garcia-Vidal C,Viasus D,et al. Clinical features,etiology,and outcomes of community-acquired pneumonia in patients with diabetes mellitus[J]. Medicine,2013,92(1):42-50. doi: 10.1097/MD.0b013e31827f602a
    [10]
    Huang D,He D,Gong L,et al. Clinical characteristics and risk factors associated with mortality in patients with severe community-acquired pneumonia and type 2 diabetes mellitus[J]. Critical Care,2021,25(1):419. doi: 10.1186/s13054-021-03841-w
    [11]
    Arias F L,Pardo S J,Cebey-López M,et al. Differences between diabetic and non-diabetic patients with community-acquired pneumonia in primary care in Spain[J]. BMC Infect Dis,2019,19(1):973. doi: 10.1186/s12879-019-4534-x
    [12]
    Cheng S,Hou G,Liu Z,et al. Risk prediction of in-hospital mortality among patients with type 2 diabetes mellitus and concomitant community-acquired pneumonia[J]. Annals of Palliative Medicine,2020,9(5):3313-3325. doi: 10.21037/apm-20-1489
    [13]
    Khan R N,Saba F,Kausar S F,et al. Pattern of electrolyte imbalance in type 2 diabetes patients: Experience from a tertiary care hospital[J]. Pakistan Journal of Medical Sciences,2019,35(3):797-801.
    [14]
    Wang S Q,Lu D X,Zhang J D,et al. The association between abnormal serum magnesium levels and prognosis of elderly patients with community-acquired pneumonia[J]. Magnesium Research,2021,34(4):159-165. doi: 10.1684/mrh.2022.0493
    [15]
    Liu X L,Wang S Q,Ji M J,et al. Hypomagnesemia is associated with increased mortality in the short-term but not the long-term in community-acquired pneumonia patients with type 2 diabetes[J]. Magnesium Research,2022,35(2):33-38. doi: 10.1684/mrh.2022.0499
    [16]
    Smith S H. Using albumin and prealbumin to assess nutritional status[J]. Nursing,2017,47(4):65-66. doi: 10.1097/01.NURSE.0000511805.83334.df
    [17]
    Li T,Guo Y,Zhuang X,et al. Abnormal liver-related biomarkers in COVID-19 patients and the role of prealbumin[J]. Saudi Journal of Gastroenterology,2020,26(5):272-278. doi: 10.4103/sjg.SJG_239_20
    [18]
    Gamarra-Morales Y,Molina-López J,Machado-Casas J F,et al. Influence of Nutritional Parameters on the Evolution,Severity and Prognosis of Critically Ill Patients with COVID-19[J]. Nutrients,2022,14(24):5363. doi: 10.3390/nu14245363
    [19]
    Zhang H F,Li L Q,Ge Y L,et al. Serum prealbumin improves the sensitivity of pneumonia severity index in predicting 30-day mortality of CAP patients[J]. Clinical Laboratory,2020,66(5):811-818.
    [20]
    Parthasarathi A,Padashetti V C,Padukudru S,et al. Association of serum albumin and copeptin with early clinical deterioration and instability in community-acquired pneumonia[J]. Advances in Respiratory Medicine,2022,90(4):323-337. doi: 10.3390/arm90040042
    [21]
    Miyazaki H,Nagata N,Akagi T,et al. Comprehensive analysis of prognostic factors in hospitalized patients with pneumonia occurring outside hospital: Serum albumin is not less important than pneumonia severity assessment scale[J]. Journal of Infection and Chemotherapy,2018,24(8):602-609. doi: 10.1016/j.jiac.2018.03.006
    [22]
    Akbar M R,Pranata R,Wibowo A,et al. The association between serum prealbumin and poor outcome in COVID-19-Systematic review and meta-analysis[J]. European Review for Medical and Pharmacological Sciences,2021,25(10):3879-3885.
    [23]
    Jensen A V,Faurholt-Jepsen D,Egelund G B,et al. Undiagnosed diabetes mellitus in community-acquired pneumonia: a prospective cohort study[J]. Clinical Infectious Diseases,2017,65(12):2091-2098. doi: 10.1093/cid/cix703
    [24]
    Al-Khlaiwi T,Alsabih A O,Khan A,et al. Reduced pulmonary functions and respiratory muscle strength in Type 2 diabetes mellitus and its association with glycemic control[J]. European Review for Medical and Pharmacological Sciences,2021,25(23):7363-7368.
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