Type 2 Diabetes Mellitus Is Not Associated with the Incidence or the Outcome of Pneumonia in Patients with Acute Ischemic Stroke

Abstract

Background/Aims: The association between T2DM and the incidence and outcome of pneumonia in patients with acute ischemic stroke is unclear. The aim of the present study was to evaluate this association. Patients and Methods: We prospectively studied 922 consecutive patients admitted with acute ischemic stroke (42.2% males, age 79.6±6.9 years). The severity of stroke was assessed at admission with the National Institutes of Health Stroke Scale (NIHSS). The outcome was assessed with dependency rates at discharge (modified Rankin scale 2-5) and in-hospital mortality. Results: During hospitalization, 113 patients developed pneumonia. Patients who developed pneumonia had higher fasting plasma glucose (FPG) levels at the second day of hospitalization than patients who did not develop pneumonia (7.4±3.4 and 6.3±2.6 mmol/l, respectively; p<0.005) whereas the prevalence of T2DM and HbA1c levels did not differ between the two groups. Independent risk factors for pneumonia were obesity (relative risk (RR) 2.05, 95% confidence interval (CI) 1.10-3.79, p<0.05) and NIHSS at admission (RR 1.13, 95% CI 1.09-1.16, p<0.001). Among patients who developed pneumonia, 50.4% were dependent at discharge and 43.4% died during hospitalization. Patients who were dependent at discharge had similar prevalence of T2DM and similar FPG and HbA1c levels with patients who were independent at discharge. Patients who died during hospitalization had higher FPG levels than patients who were discharged (8.3±4.4 and 6.7±2.3 mmol/l, respectively; p<0.05) whereas the prevalence of T2DM and HbA1c levels did not differ between the two groups. Independent risk factors for in-hospital mortality were diastolic blood pressure at admission (RR 1.05, 95% CI 1.01-1.09, p<0.05) and NIHSS at admission (RR 1.16, 95% CI 1.09-1.23, p<0.001). Conclusions: T2DM does not appear to be associated with the incidence or the outcome of pneumonia in patients admitted with acute ischemic stroke. Disclosure M. Papagianni: None. K. Tziomalos: None. S. Kostaki: None. S. Angelopoulou: None. K. Christou: None. A. Sofogianni: None. S. Alkagiet: None. T. Didangelos: None. C. Savopoulos: None. A.I. Hatzitolios: None.