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Abstract
BackgroundPneumonia is one of the most common diseases with a high hospitalization rate. Many studies have suggested that there is a correlation between pre-existing diabetes and the alterations in serum glucose levels in patients with community-acquired pneumonia (CAP) and high death rate.AimTo study the impact of admission blood glucose level on patients’ outcomes with CAP.Patients and methodsSixty (30 nondiabetic and 30 diabetic patients) consecutive hospitalized adult patients with CAP were recruited over a 1-year period. Data on patients’ outcomes including duration of hospital stay, duration of antibiotic treatment, increase in oxygen requirements, increase in antibiotics coverage, ICU admission, mechanical ventilation, and in-hospital mortality were collected.ResultsAdmission blood glucose level was elevated in diabetic patients (the mean plasma glucose level was 258.86 ±116.15 mg/dl in diabetics and 151.13±51.23 mg/dl in nondiabetics). There were statistically significant increases in the duration of hospital stay (7.633±3.567 nondiabetic vs. 11.267±4.291 diabetic patients in days), duration of antibiotic treatment (7.633±3.567 nondiabetic vs. 11.267±4.291 diabetic patients in days), increase in O2 requirements (33.33 vs.70%), increase in antibiotics coverage (16.67 vs. 63.33%), and ICU admission (30 vs. 63.33%) in the diabetic group on comparing nondiabetic versus diabetic patients with CAP. Also, the previously mentioned outcomes increased significantly with increasing blood glucose levels among the entire study population.ConclusionOn admission, CAP patients with increased blood glucose level, either diabetic or nondiabetic, are expected to have poor outcomes.
Highlights
Community-acquired pneumonia (CAP) is a common disease that leads to significant morbidity and mortality, and its annual incidence varies from 5 to 11/1000 population; 20% of these patients require hospitalization, which places a significant economic burden on the society [1].Hyperglycemia has a major influence on the function of the immune system; it combines in-vitro with ingredients of the innate immune system [2] and combines with the adaptive immune system, causing direct inhibition of T-lymphocyte, immunoglobulin, and complement functions [3].Hyperglycemia can occur because of diabetes mellitus or stress
Admission blood glucose level was elevated in diabetic patients
552 Egyptian Journal of Bronchology, Vol 13 No 4, October-December 2019 divided according to information collected about diabetes into 30 nondiabetic patients and 30 diabetic patients
Summary
Community-acquired pneumonia (CAP) is a common disease that leads to significant morbidity and mortality, and its annual incidence varies from 5 to 11/1000 population; 20% of these patients require hospitalization, which places a significant economic burden on the society [1].Hyperglycemia has a major influence on the function of the immune system; it combines in-vitro with ingredients of the innate immune system [2] and combines with the adaptive immune system, causing direct inhibition of T-lymphocyte, immunoglobulin, and complement functions [3].Hyperglycemia can occur because of diabetes mellitus or stress. Community-acquired pneumonia (CAP) is a common disease that leads to significant morbidity and mortality, and its annual incidence varies from 5 to 11/1000 population; 20% of these patients require hospitalization, which places a significant economic burden on the society [1]. Hyperglycemia on admission is considered an absolute risk factor for higher complication rates and higher mortality in patients with CAP with or without diabetes [5]. It is crucial to study the impact of admission blood glucose levels on outcomes in patients with CAP in our hospital. Pneumonia is one of the most common diseases with a high hospitalization rate. Many studies have suggested that there is a correlation between pre-existing diabetes and the alterations in serum glucose levels in patients with community-acquired pneumonia (CAP) and high death rate
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