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2013 ; 92
(1
): 42-50
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Clinical features, etiology, and outcomes of community-acquired pneumonia in
patients with diabetes mellitus
#MMPMID23263718
Di Yacovo S
; Garcia-Vidal C
; Viasus D
; Adamuz J
; Oriol I
; Gili F
; Vilarrasa N
; García-Somoza MD
; Dorca J
; Carratalà J
Medicine (Baltimore)
2013[Jan]; 92
(1
): 42-50
PMID23263718
show ga
We performed an observational analysis of a prospective cohort of immunocompetent
hospitalized adults with community-acquired pneumonia (CAP) to determine the
epidemiology, clinical features, and outcomes of pneumonia in patients with
diabetes mellitus (DM). We also analyzed the risk factors for mortality and the
impact of statins and other cardiovascular drugs on outcomes. Of 2407 CAP
episodes, 516 (21.4%) occurred in patients with DM; 483 (97%) had type 2
diabetes, 197 (40%) were on insulin treatment, and 119 (23.9%) had end-organ
damage related to DM. Patients with DM had different clinical features compared
to the other patients. They were less likely to have acute onset, cough, purulent
sputum, and pleural chest pain. No differences in etiology were found between
study groups. Patients with DM had more inhospital acute metabolic complications,
although the case-fatality rate was similar between the groups. Independent risk
factors for mortality in patients with DM were advanced age, bacteremia, septic
shock, and gram-negative pneumonia. Patients with end-organ damage related to DM
had more inhospital cardiac events and a higher early case-fatality rate than did
the overall population. The use of statins and other cardiovascular drugs was not
associated with better CAP outcomes in patients with DM. In conclusion, CAP in
patients with DM presents different clinical features compared to the features of
patients without DM.