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Outcomes of hyperglycemia in patients with and without diabetes hospitalized for infectious diseases
Author(s) -
Akirov Amit,
DikerCohen Talia,
MasriIraqi Hiba,
DuskinBitan Hadar,
Shimon Ilan,
Gorshtein Alexander
Publication year - 2018
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.3027
Subject(s) - medicine , diabetes mellitus , glycemic , genitourinary system , cohort , respiratory tract infections , skin infection , cohort study , surgery , respiratory system , insulin , staphylococcus aureus , endocrinology , biology , bacteria , genetics
Abstract Objective To examine the prognostic implications of diabetes mellitus (DM) and the importance of glycemic control during hospitalization for infectious diseases. Methods Historical prospectively collected data of patients hospitalized between 2011 and 2013. Infection‐related hospitalizations were classified according to site of infection. Median follow‐up was 4.5 years. Outcome measures included in‐hospital and end‐of‐follow‐up mortality. Results The cohort included 8051 patients (50% female, mean age ± SD, 68 ± 20 years) with a primary diagnosis of an infectious disease. Of these, 2363 patients (29%) had type 2 DM. The most common infectious sites included respiratory tract ( n = 3285), genitourinary tract ( n = 1804), skin and soft tissue ( n = 934) and gastrointestinal tract ( n = 571). There was no difference in admission rates of patients with and without DM according to the site of infection, except for skin and soft tissue infection which were more common among patients with DM (16% vs 10%). In‐hospital mortality risk was greater in patients with DM (aOR = 1.3, 95% CI = 1.1‐1.7). In the entire cohort, adjusted mortality risk (aHR, 95% CI) at the end‐of‐follow‐up was greater among patients with DM (1.2, 1.1‐1.4), with increased mortality risk following hospitalization for respiratory (1.1, 1.0‐1.4) and skin and soft tissue infections (1.7, 1.3‐2.3). In‐hospital and end‐of‐follow‐up mortality risk were highest among patients with and without DM with median glucose >180 mg/dL during hospitalization. Conclusions In patients hospitalized for infectious diseases, DM is associated with increased long‐term mortality risk, specifically following hospitalization for respiratory and skin and soft tissue infections. Poor glycemic control during hospitalization is associated with increased long‐term mortality.