Propensity score study of the relationship between random blood glucose level and clinical outcomes of elderly patients with community-acquired pneumonia

Abstract

Objective To investigate the correlation between admission hyperglycemia and clinical prognosis in elderly patients with community-acquired pneumonia. Methods Based on the electrical medical record (EMR), information of the patients with pneumonia was retrospectively collected and the necessary data were prepared and arranged.Based on clinical outcomes, demographic characteristics and clinical indicators were compared between groups in order to screen potential variables affecting clinical outcomes.Then, the random blood glucose level 8.6 mmol/L was considered to be the cutoff point for grouping patients, with clinical outcomes as outcome variables, random blood glucose levels as grouping variables, propensity score value analysis method was applied along with the ratio of 1: 1 nearest neighbor matching method to generate paired samples in order to assess the impact of blood glucose level on mortality rate; With hospitalization time serving as time variable, survive analysis method was used to analyze COX proportional model. Results Five hundred and fifty-eight patients were enrolled in the analysis, 197 patients of which were recorded dead during hospitalization (the dead group). After the correction of demographic characteristics, past medical history and blood test indexes, white blood cells, C reactive protein, random blood glucose at admission and triglyceride levels were regarded as potential factors for the deaths of patients (P<0.05). However, the propensity score analysis method suggested that there was no significant difference between the blood glucose levels and mortality.The survival analysis showed that the mortality in the high blood glucose group was higher than that in the normal blood glucose group (HR=1.68, 95%CI(1.22, 2.31) ). Conclusion Admission hyperglycemia is an important indicator of adverse prognosis in elderly patients with pneumonia.It may be of significance for screening and identifying high-risk patients. Key words: The elderly; Pneumonia; Random blood glucose; Clinical outcome