Abstract
The occult pulmonary infection is the most common complications in elderly patients with type 2 diabetes mellitus (T2DM). Since its etiological characteristics has not been clarified, infection control remains a serious problem for public health. To investigate the prevalence and clinical significance of occult pulmonary infection in elderly T2DM patients, in this study, 573 elderly patients cochallenged with T2DM and community-acquired pulmonary infection from January 2018 to December 2020 were selected in the hospitals and divided into occult pneumonia group (OP, n = 249) and nonoccult pneumonia group (NOP, n = 324) according to the nature of infection. Clinical medical records were analyzed retrospectively to summarize the infection characteristics of elderly diabetics with occult pneumonia. The prevalence of the cases (278/324, 85.8%) in NOP group was not higher than that in OP group (206/249, 82.7%; P > 0.05). Also, there was not significant difference in the distribution of isolated pathogens among the positive patients. The length of hospitalization and mortality of OP patients were significantly higher than those NOP patients. Multivariate logistic regression showed that advanced age, comorbidities, hypothyroidism, senile dementia, and prolonged bed rest were independent risk factors for occult pneumonia in elderly diabetic patients. Therefore, the results demonstrated that the pulmonary infection in elderly patients with diabetes mellitus is often occult. Gram-negative bacteria are the predominant pathogens and cause poor prognosis. Advanced age, comorbidities (senile dementia, hypothyroidism), and prolonged bed rest are the independent risk factors for occult pneumonia.
Highlights
Diabetes mellitus is an endocrine and metabolic disease with high incidence and genetic tendency, which seriously affects the quality of life of patients and their offspring [1]
Several reasons have been found: (1) high blood glucose levels provide good growth conditions for pathogenic bacteria, which facilitates their mass multiplication; (2) hyperglycemia increases plasma osmotic pressure and attenuates the chemotaxis, phagocytosis, and bactericidal ability of neutrophils, resulting in decreased clearance of pulmonary pathogens; (3) hyperglycemia can reduce cellular immunity and the body’s anti-infective ability, increasing the risk of infection; (4) diabetes mellitus is often associated with uremia, ketoacidosis, and other complications
Occult pneumonia refers to insidious clinical symptoms and/or insidious lesion sites, which are not diagnosed at the initial diagnosis, often without typical symptoms of respiratory tract infection such as cough, sputum, and chest pain, and are mostly seen in the elderly population
Summary
Diabetes mellitus is an endocrine and metabolic disease with high incidence and genetic tendency, which seriously affects the quality of life of patients and their offspring [1]. Scholars do not have a precise definition and diagnostic criteria for occult pulmonary infection, but most elderly patients have multiple underlying diseases. BioMed Research International progress of the disease and even endanger lives of patients [16]. Understanding the clinical status and risk factors of occult pulmonary infection in elderly patients with T2DM is of great clinical significance for controlling infection and improving the prognosis of patients. The case data of elderly patients with T2DM complicated with community-acquired pulmonary infection were retrospectively analyzed; the clinical etiological characteristics, treatment, and prognosis of such patients were summarized; and their risk factors were preliminarily analyzed to provide reference for clinical intervention
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
