PNEUMONIA AND MORTALITY RISK: STUDY ON DIABETIC AND NON-DIABETIC PATIENTS

  • NARMADHA MP Department of Pharmacy Practice, Nehru College of Pharmacy, Thrissur, Kerala, India.
  • NIKHNA JAYAN Department of Pharmacy Practice, Nehru College of Pharmacy, Thrissur, Kerala, India.
  • RON JOHNY Department of Pulmonary, Medicine, Valluvanad Hospital Complex Ltd., Kerala, India.

Abstract

Objective: Pneumonia, a frequent coexistent of diabetes, is an important cause of morbidity and mortality in diabetes. The diabetic population is not only prone to pulmonary infection but it is also prone to different comorbidity and complication. Therefore, the aim of the study was to assess and compare mortality in diabetic pneumonia and non-diabetic pneumonia group.


Methods: This was a prospective case–control study conducted in two hospitals which included 76 patients with Group 1 (patients with diabetics) and 70 patients with Group 2 (patients who are non-diabetics).


Results: Among 146 patients, mortality in diabetics was 5.47% in comparison with non-diabetics 4.10%. Patients in the diabetic group were significantly (p=0.044) more among pneumonia severity index (PSI) Class IV–V (9.21%) than PSI Class I-III (1.31%). Most of the patients had predisposing condition or underlying disease, hypertension (87.50% vs. 50%), pulmonary (37.50% vs. 83.33%), neurological (37.50% vs. 83.33%), and renal disease (37.5% in diabetic). The common complication in both groups was pleural effusion (50%) and septic shock (25%). Gram-negative bacteria (62.5% vs. 33.33%) and drug-resistant pathogens score (87.5% vs. 66.66%) were more prevalent in both groups.


Conclusion: Our study reveals that poor long-term glycemic control among patients with diabetes clearly increases the risk of hospitalization and mortality. In non-diabetic pneumonia patients, antibiotic-resistant bacteria and preexisting pulmonary disease act as a predictor for mortality.

Keywords: Diabetes mellitus, Pneumonia, Pneumonia severity index score, Morbidity, Mortality

References

1. Berk SL. Bacterial pneumonia in the elderly: The observations of Sir William Osler in retrospect. J Am Geriatr Soc 1984;32:683-5.
2. Kumar TC, Rafiudeen R, Rashmi K. A study of clinical and etiological profile of community-acquired pneumonia with special reference to atypical pneumonia. Ann Nigerian Med 2017;11:6-11.
3. Cilloniz C, Martin-Loeches I, Garcia-Vidal C, San Jose A, Torres A. Microbial etiology of pneumonia: Epidemiology, diagnosis and resistance patterns. Int J Mol Sci 2016;17:2120.
4. Pachon J, Prados MD, Capote F, Cuello JA, Garnacho J, Verano A. Severe Community acquired pneumonia. Etiology, prognosis and treatment. Am Rev Respir Dis 1990;142:369-73.
5. Fissell WH. Antimicrobial dosing in acute renal replacement. Adv Chronic Kidney Dis 2013;20:85-93.
6. Fine MJ, Smith MA, Carson CA, Mutha SS, Sankey SS, Weissfeld LA, et al. Prognosis and outcomes of patients with community-acquired pneumonia. A meta-analysis. JAMA 1995;274:134-40.
7. Webb BJ, Dascomb K, Stenehjem E, Vikram HR, Agrwal N, Sakata K, et al. Derivation and multicenter validation of the drug resistance in pneumonia clinical prediction score. Antimicrob Agents Chemother 2016;60:2652-63.
8. Bhambar S, Deore P, Rathod R, Janrao S. Pneumonia in diabetics: Clinico-bacteriological profile and outcome. Int J Med Health Res 2017;3:62-6.
9. Falguera M, Pifarre R, Martin A, Sheikh A, Moreno A. Etiology and outcome of community acquired pneumonia in patients with diabetes mellitus. Chest 2005;128:3233-9.
10. Akbar DH. Bacterial pneumonia: Comparison between diabetics and non-diabetics. Acta Diabetol 2001;38:77-82.
11. Kornum JB, Thomsen RW, Riis A. Diabetes glycemic control and risk of hospitalization with pneumonia. Diabetes Care 2008;31:1541-5.
12. Pachon J, Prados MD, Capote F, Cuello JA, Garnacho J, Verano A. Severe Community acquired pneumonia. Etiology, prognosis and treatment. Am Rev Respir Dis 1990;142:369-73.
13. Shyama K, Prudence AR. Improving antibiotic prescribing pattern and assessment of Co-morbidities associated with respiratory tract infections. Int J Pharm Pharm Sci 2017;9:283-6.
14. Benfield T, Jensen JS, Nordestgaard BG. Influence of diabetes and hyperglycaemia on infectious disease hospitalisation and outcome. Diabetologia 2007;50:549-54.
15. Valdez R, Narayan KM, Geiss LS, Engelgau MM. Impact of diabetes mellitus on mortality associated with pneumonia and influenza among non-Hispanic black and white US adults. Am J Public Health 1999;89:1715-21.
16. Khan MA, Naqvi SB, Alam S, Ali SI, Rizvi M, Hussain M, et al. Survey base study on current trend of treatment of community-acquired pneumonia in Karachi. Int J Pharm Pharm Sci 2015;7:162-7.
Statistics
27 Views | 38 Downloads
Citatons
How to Cite
MP, N., N. JAYAN, and R. JOHNY. “PNEUMONIA AND MORTALITY RISK: STUDY ON DIABETIC AND NON-DIABETIC PATIENTS”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 13, no. 8, June 2020, pp. 188-91, doi:10.22159/ajpcr.2020.v13i8.37267.
Section
Original Article(s)