Isabel Jiménez-Trujillo1, Rodrigo Jiménez-García2, Javier de Miguel-Díez3, José M de Miguel-Yanes4, Valentín Hernández-Barrera1, Manuel Méndez-Bailón5, Napoleón Pérez-Farinós6, Miguel-Ángel Salinero-Fort7, Ana López-de-Andrés1. 1. Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Comunidad de Madrid, Spain. 2. Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Comunidad de Madrid, Spain. Electronic address: rodrigo.jimenez@urjc.es. 3. Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Comunidad de Madrid, Spain. 4. Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Madrid, Comunidad de Madrid, Spain. 5. Internal Medicine Department, Hospital Universitario Clínico San Carlos, Madrid, Comunidad de Madrid, Spain. 6. Health Security Agency, Ministry of Health, Social Services and Equality, Madrid, Comunidad de Madrid, Spain. 7. Subdirección General de Investigación Sanitaria, Consejería de Sanidad, Madrid, Spain.
Abstract
BACKGROUND: To describe incidence, characteristics and outcomes of ventilator-associated pneumonia (VAP) during hospitalization among patients with or without type 2 diabetes (T2DM). METHODS: We used the Spanish national hospital discharge database to select all hospitalization with VAP in subjects aged 40years or more from 2010 to 2014. We analyzed incidence, patient comorbidities, procedures, pneumonia pathogens and in-hospital outcomes according to diabetes status (T2DM and no-diabetes). We used propensity score analysis to estimate the effect of T2DM on in-hospital mortality RESULTS: In 7952 admissions, the patient developed a VAP (13.6% with T2DM). Adjusted incidence rate of VAP was slightly, but significantly, higher in T2DM than in non-diabetic patients (36.46[95% CI 34.41-38.51] vs. 32.57[95% CI 31.40-33.74] cases per 100,000/inhabitants). T2DM people were older and had higher Charlson comorbidity index than non-diabetic people. T2DM patients had a lower mean number of failing organs than non-diabetic patients (1.20 SD 1.17 vs. 1.45 SD 1.44, p<0.001). Pseudomonas was the most frequently isolated agent in both groups. IHM was 41.92% for T2DM patients and 37.91% for non-diabetic patients (p<0.05). Factors associated with a higher mortality in both groups included: older age, more comorbidities and primary diagnoses of vein or artery occlusion, pulmonary disease and cancer. T2DM was not associated with a higher in-hospital mortality after adjustment using a propensity score (OR 0.88; 95% CI 0.76-1.35). CONCLUSIONS: VAP incidence rates were higher among T2DM patients. In-hospital mortality was higher among the older patients and those with more co-morbid conditions. T2DM does not predict higher mortality in VAP during hospitalization.
BACKGROUND: To describe incidence, characteristics and outcomes of ventilator-associated pneumonia (VAP) during hospitalization among patients with or without type 2 diabetes (T2DM). METHODS: We used the Spanish national hospital discharge database to select all hospitalization with VAP in subjects aged 40years or more from 2010 to 2014. We analyzed incidence, patient comorbidities, procedures, pneumonia pathogens and in-hospital outcomes according to diabetes status (T2DM and no-diabetes). We used propensity score analysis to estimate the effect of T2DM on in-hospital mortality RESULTS: In 7952 admissions, the patient developed a VAP (13.6% with T2DM). Adjusted incidence rate of VAP was slightly, but significantly, higher in T2DM than in non-diabeticpatients (36.46[95% CI 34.41-38.51] vs. 32.57[95% CI 31.40-33.74] cases per 100,000/inhabitants). T2DM people were older and had higher Charlson comorbidity index than non-diabeticpeople. T2DM patients had a lower mean number of failing organs than non-diabeticpatients (1.20 SD 1.17 vs. 1.45 SD 1.44, p<0.001). Pseudomonas was the most frequently isolated agent in both groups. IHM was 41.92% for T2DM patients and 37.91% for non-diabeticpatients (p<0.05). Factors associated with a higher mortality in both groups included: older age, more comorbidities and primary diagnoses of vein or artery occlusion, pulmonary disease and cancer. T2DM was not associated with a higher in-hospital mortality after adjustment using a propensity score (OR 0.88; 95% CI 0.76-1.35). CONCLUSIONS: VAP incidence rates were higher among T2DM patients. In-hospital mortality was higher among the older patients and those with more co-morbid conditions. T2DM does not predict higher mortality in VAP during hospitalization.
Authors: Javier de Miguel-Díez; Ana López-de-Andrés; Valentín Hernández-Barrera; Isabel Jiménez-Trujillo; Manuel Méndez-Bailón; José M de Miguel-Yanes; Benito Del Rio-Lopez; Rodrigo Jiménez-García Journal: Medicine (Baltimore) Date: 2017-07 Impact factor: 1.889
Authors: Ana Lopez-de-Andres; Romana Albaladejo-Vicente; Javier de Miguel-Diez; Valentin Hernandez-Barrera; Zichen Ji; Jose J Zamorano-Leon; Marta Lopez-Herranz; Rodrigo Jimenez-Garcia Journal: BMJ Open Diabetes Res Care Date: 2020-06
Authors: Ana López-de-Andrés; Napoleon Perez-Farinos; Javier de Miguel-Díez; Valentín Hernández-Barrera; Isabel Jiménez-Trujillo; Manuel Méndez-Bailón; José M de Miguel-Yanes; Rodrigo Jiménez-García Journal: PLoS One Date: 2019-02-06 Impact factor: 3.240
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Authors: Ana Lopez-de-Andres; Marta Lopez-Herranz; Valentin Hernandez-Barrera; Javier de-Miguel-Diez; Jose M de-Miguel-Yanes; David Carabantes-Alarcon; Romana Albaladejo-Vicente; Rosa Villanueva-Orbaiz; Rodrigo Jimenez-Garcia Journal: Int J Environ Res Public Health Date: 2021-11-30 Impact factor: 3.390