University of Kansas School of Medicine, Kansas City, KS, USA.
Int J Gen Med. 2013 May 6;6:341-4. doi: 10.2147/IJGM.S42854. Print 2013.
Community-acquired pneumonia (CAP) is a common cause of morbidity and mortality in older adults. Although diabetes mellitus is a risk factor for pneumonia, the clinical impact of blood glucose level at the time of admission is not clear. Our goal was to examine the association between admission hyperglycemia and subsequent mortality, length of stay, and readmission outcomes in older adults with CAP.
A retrospective observational study was conducted using hospital data for community-acquired pneumonia admissions in 857 persons from January 1, 2008 to December 31, 2010. We examined the effects of admission glucose level on mortality, length of stay, and 30 day readmission, adjusted for demographic factors and comorbidity.
The mean age of the sample was 64 years, and 51% of the subjects were female. Inpatient mortality occurred in 4.6% and the median length of stay was 5 days (interquartile range 3-9 days). Readmission within 30 days occurred in 17%. We found little impact of first glucose measures on in-hospital mortality (P = 0.94), length of stay (P = 0.95), and 30-day readmission (P = 0.56). Subjects 65 years and older trended towards higher in-hospital mortality. Older age, cancer, heart failure, and cirrhosis were associated with adverse outcomes.
Glucose level upon admission for community-acquired pneumonia was not associated with adverse outcomes within 30 days in older adults.
社区获得性肺炎（CAP）是导致老年人发病和死亡的常见病因。尽管糖尿病是肺炎的危险因素，但目前尚不清楚入院时血糖水平的临床影响。我们的目标是研究入院时高血糖与老年人 CAP 患者的死亡率、住院时间和 30 天再入院结局之间的相关性。
采用回顾性观察性研究，利用 2008 年 1 月 1 日至 2010 年 12 月 31 日期间 857 名社区获得性肺炎入院患者的医院数据进行研究。我们考察了入院时血糖水平对死亡率、住院时间和 30 天再入院的影响，这些影响是在调整了人口统计学因素和合并症之后得出的。
样本的平均年龄为 64 岁，51%的受试者为女性。住院死亡率为 4.6%，中位住院时间为 5 天（四分位间距 3-9 天）。30 天内再入院率为 17%。我们发现首次血糖测量对住院死亡率（P = 0.94）、住院时间（P = 0.95）和 30 天再入院率（P = 0.56）的影响不大。65 岁及以上的患者住院死亡率呈上升趋势。年龄较大、癌症、心力衰竭和肝硬化与不良结局相关。
老年人社区获得性肺炎入院时的血糖水平与 30 天内的不良结局无关。
