The Impact of Diabetes Mellitus in Patients with Chronic Obstructive Pulmonary Disease (COPD) Hospitalization.

Kulothungan Gunasekaran,Krishna Prasad Kolandaivel,Mandeep Singh Rahi,Arul Chandran,Vijaya Kumar Paramasivam,Kalaimani Elango,Ashish Arora,Dinesh Voruganti,Swetha Murthi,Bright Thilagar,Sathishkumar Ramalingam

doi:10.3390/jcm10020235

Abstract

(1) Background: Chronic obstructive pulmonary disease (COPD) is the leading cause of morbidity and mortality worldwide. Diabetes mellitus (DM) has been shown to have adverse inflammatory effects on lung anatomy and physiology. We investigated the impact of DM on COPD patient outcomes during inpatient hospitalization. (2) Methods: We conducted a retrospective analysis using the Nationwide Inpatient Sample (NIS) over the years 2002–2014. Three groups, COPD without diabetes, COPD with diabetes but no complication, and COPD with DM and complication, were analyzed. (3) Results: A total of 7,498,577 were COPD hospitalization; of those, 1,799,637 had DM without complications, and 483,467 had DM with complications. After adjusting for clinical, demographic, and comorbidities, the odds of increased LOS in the COPD/DM with complication were 1.37 (confidence interval (CI): 1.326–1.368), and those of DM without complication were 1.061 (1.052–1.070) when compared with COPD alone. The odds of pneumonia, respiratory failure, stroke, and acute kidney injury were also higher in COPD hospitalizations with DM. Both DM with complication (odds ratio (OR): 0.751 (CI 0.727–0.777)) and DM without complication (OR: 0.635 (CI: 0.596–0.675)) have lesser odds of mortality during hospitalization than with COPD alone. (4) Conclusions: There is a considerable inpatient burden among COPD patients with DM in the United States.

Highlights

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes progressive airflow obstruction, which is not fully reversible
About 30.3% of COPD patients without Diabetes mellitus (DM) were current smokers compared with 26% and 24% in diabetic patients without complications and with complications, respectively (p < 0.001) (Table 1)
Our study showed that COPD with diabetes has an increased risk of pneumonia and respiratory failure

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes progressive airflow obstruction, which is not fully reversible. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2020 report, COPD is the leading form of lung disease causing morbidity and mortality worldwide. It is associated with a substantially increasing economic and social burden [1,2]. There were about 3 million deaths due to COPD annually [4]. There may be more than 5.4 million annual deaths from COPD and related conditions in 2060 [5]

Methods

Results

Conclusion