Journal Article

Relation Between Hyperglycemia and Outcomes in 2,471 Patients Admitted to the Hospital With Community-Acquired Pneumonia

McAlister, Finlay A, Majumdar, Sumit R, Marrie, Thomas J, Rowe, Brian H, Blitz, Sandra, Romney, Jacques

2005

Overview

OBJECTIVE:-- To examine whether hyperglycemia at the time of presentation was associated with outcomes in patients admitted to non-intensive care settings with community-acquired pneumonia (CAP). RESEARCH DESIGN AND METHODS-- Prospective cohort study of consecutive patients admitted to six hospitals between 15 November 2000 and 14 November 2002. RESULTS:-- Of the 2,471 patients in this study (median age 75 years), 279 (11%) had serum glucose at presentation >11 mmol/l: 178 of the 401 patients (44%) with a prior diagnosis of diabetes and 101 of the 2,070 patients (5%) without a history of diabetes. Of patients hospitalized with CAP, 9% died and 23% suffered an in-hospital complication. Compared with those with values 11 mmol/l had an increased risk of death (13 vs. 9%, P = 0.03) and in-hospital complications (29 vs. 22%, P = 0.01). Compared with those patients with admission glucose 11 mmol/l. Even after adjustment for factors in the Pneumonia Severity Index, hyperglycemia on admission remained significantly associated with subsequent adverse outcomes: for each 1-mmol/l increase, risk of in-hospital complications increased 3% (0.2-6%). CONCLUSIONS:-- Hyperglycemia on admission is independently associated with adverse outcomes in patients with CAP, with the increased risks evident at lower glucose levels than previously reported.

• Publisher: American Diabetes Association
• Subject: Aged / Alberta / Alberta - epidemiology / Bacterial diseases / Bacterial diseases of the respiratory system / Bacterial pneumonia / Biological and medical sciences / blood glucose / Causes of / Clinical outcomes / cohort studies / Community-Acquired Infections / Community-Acquired Infections - complications / Community-Acquired Infections - mortality / complications / Complications and side effects / death / Diabetes / Diabetes. Impaired glucose tolerance / Endocrine pancreas. Apud cells (diseases) / Endocrinopathies / epidemiology / Female / Glucose / Homes for the Aged / Hospital Mortality / hospitals / Human bacterial diseases / Humans / Hyperglycemia / Hyperglycemia - complications / Hyperglycemia - mortality / Infectious diseases / Inpatients / Length of Stay / Male / Medical sciences / Metabolism / mortality / Nursing Homes / patients / Pneumonia / Pneumonia - complications / risk / Risk Factors / Survival Analysis / Treatment Outcome