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17-06-2010 | Diabetes | Article

Patients with COPD and diabetes have increased in hospital mortality

Abstract

Free abstract

MedWire News: Patients who are hospitalized for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) who also have diabetes have higher in hospital mortality and are likely to be hospitalized for longer than nondiabetics, say researchers

“Hyperglycemia during hospital admission is associated with poor outcomes in patients admitted with acute myocardial infarction, stroke, and pneumonia,” explain Guy Marks (Woolcock Institute of Medical Research, Sydney, New South Wales, Australia) and colleagues.

But they add: “There is limited published evidence about the effect of comorbid diabetes mellitus on clinical outcomes in patients hospitalized with an AECOPD.”

To investigate further, the researchers studied data on 172 patients who had been admitted to a large tertiary hospital at least once in 2007 suffering from an AECOPD.

Of the 246 admissions assessed, 53 (22%) occurred in patients with diagnosed diabetes mellitus, and in 47 (89%) of these admissions the patient was on therapy for diabetes mellitus at the time of presentation.

The researchers found that the mean length of hospital stay among patients with diabetes mellitus was 7.8 days compared with 6.5 days among those without diabetes mellitus. After accounting for factors such as age, gender, smoking status, the need for non-invasive ventilation, and the presence of other conditions and diseases, they found that length of hospital stay was a nonsignificant 10.3% longer in patients with diabetes mellitus than in those without the condition.

The team also found that 8.0% of patients with diabetes died after hospital admission compared with just 4.0% of those without the condition. After adjustment for confounding variables, patients with diabetes had a non-significant 1.93-fold increased risk for death compared with those without diabetes mellitus.

“This study shows a trend towards increased length of stay and increased deaths among patients admitted with AECOPD who have comorbid diabetes mellitus as compared with those not diagnosed with diabetes mellitus,” comment Marks and team in the journal Respirology.

They conclude: “Our study supports the view that diabetes mellitus may be an adverse prognostic factor for patients admitted with an AECOPD.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Mark Cowen