Type 2 diabetes and postoperative pneumonia: An observational, population-based study using the Spanish Hospital Discharge Database, 2001-2015

Abstract

PurposeWe analyzed temporal trends, demographic and clinical characteristics and hospital mortality rates of postoperative pneumonia among type 2 diabetes mellitus (T2DM) patients in Spain from 2001 to 2015. We also compared the incidence, comorbidities and mortality between patients with and without T2DM suffering from postoperative pneumonia. Finally, we analyzed the factors involved in the prediction of in-hospital mortality among patients suffering postoperative pneumonia.MethodsWe used the Spanish National Hospital Discharge Database for the period 2001–2015. We analyzed patients aged 40 years or over who had been hospitalized for a surgical procedure and suffered pneumonia or ventilator-associated pneumonia during their hospital admission. We compared patients with and without T2DM. The main outcome measures were the type of surgical procedure, the presence of a comorbidity, the type of isolated pathogens, admission to the emergency room (ER) and in-hospital mortality (IHM).ResultsWe selected 117,665 hospitalized patients who suffered postoperative pneumonia (16.9% with T2DM). After multivariable adjustment, T2DM patients had a 21% higher incidence of postoperative pneumonia than nondiabetic patients (IRR 1.21, 95% CI 1.03–1.42). The IHM was approximately 31% in both groups. Predictors of IHM included age, the presence of comorbidities, treatment with a pleural drainage tube, dialysis, blood transfusion, mechanical ventilation and admission to the ER. From 2001 to 2015, the IHM decreased significantly in both populations. Suffering from T2DM was not a predictor of IHM (OR 0.99, 95% CI 0.96–1.03) in our investigation.ConclusionsT2DM patients have a higher incidence of postoperative pneumonia than those without this disease. The IHM decreased from 2001 to 2015, regardless of T2DM status. T2DM did not predict a higher IHM after suffering from postoperative pneumonia.

<p>The Effects of Type 2 Diabetes and Postoperative Pneumonia on the Mortality in Inpatients with Surgery</p>

“…Consistent with previous results, [10][11][12] patients with T2DM were more likely to have postoperative pneumonia after surgery. Unlike previous studies, the incidences of postoperative pneumonia were analyzed in different age groups in our study.…”

“…Spanish Hospital Discharge Database shows that T2DM patients had a 21% higher incidence of postoperative pneumonia than nondiabetic patients in 2001-2015. 10 The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database also shows that T2DM was found to be an independent risk factor for postoperative pneumonia in orthopedic surgery. 11,12 Postoperative pneumonia was a major cause of mortality after surgery.…”

Prevalence of diabetes mellitus in 2019 novel coronavirus: A meta-analysis

“…Previous report showed that diabetes mellitus had been linked with an increased risk of infectious disease hospitalization [14]. Former study demonstrated that the incidence of postoperative pneumonia was higher in T2DM patients than in those without this disease [15]. Another study indicated that the long-term mortality in community-acquired pneumonia among patients with undiagnosed diabetes mellitus was higher than patients without diabetes mellitus [16].…”

<p>Preoperative Serum Albumin Level As A Predictor Of Postoperative Pneumonia After Femoral Neck Fracture Surgery In A Geriatric Population</p>

“…Prior studies have identified numerous patient-related or procedure-related risk factors for POP after femoral neck fracture surgery. In most but not all studies, multiple variables, including older age, male sex, and the presence of several key clinical comorbidities such as chronic obstructive pulmonary disease (COPD), 5 obesity, 7,8 tobacco smoking, 9 prior stroke, 3 impaired preoperative pulmonary function, 10,11 cognitive and functional premorbid status 12 and cardiovascular disease 3 have been identified as risk factors for POP.…”