Glucose Levels May Predict Pneumonia Death Risk

Nondiabetic patients who have high blood glucose on admission for community-acquired pneumonia (CAP) are at significantly elevated risk for death and may benefit from intensified care.

There is a strong association between diabetes and cardiovascular disease that contributes to overall mortality from CAP and infection and acute hyperglycemia, related illnesses.

At the University Hospital of Saarland (Homburg, Germany) scientists carried out a prospective multicenter study on 6,891 patients from 12 clinical centers. The study began in July 2002, and was analyzed in December 2009. The mean age of participants was 59.8 ±18.5 years and 3,805 (55.2%) were men. Overall, 324 (4.7%) participants died within 28 days, 514 (7.5%) within 90 days, and 648 (9.4%) within 180 days. Overall mortality on days 28, 90, and 180 was significantly higher in participants with diabetes than without diabetes.

Higher serum glucose levels were associated with increased mortality in all patients. Mortality within 90 days increased in a stepwise manner in those with glucose concentrations of 108-197 mg/dL, 198-251 mg/dL, and equal or greater than 252 mg/dL when compared with patients with normal serum glucose concentrations of 72-107 mg/dL. Nondiabetics with normal blood glucose levels had the lowest 90-day mortality rate of 3%, while those with hyperglycemia had a mortality rate of 10%, and patients with diabetes had the highest death rate at 14%, irrespective of glucose levels on admission.

The authors concluded that patients with increased serum glucose levels or diabetes at the time of CAP was diagnosed were at significantly increased risk of death from the disease. Oral glucose tolerance test and close glucose monitoring after discharge are necessary to diagnose overt diabetes and to prevent subacute or long-term complications. The study was published on May 29, 2012, in the British Medical Journal (BMJ).

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University Hospital of Saarland