Diffusion Lung Capacity Predicts Hospitalization for Pneumonia in Patients with Type 2 Diabetes Mellitus

1Northwestern University, Chicago, IL
2Northwestern University, Chicago, IL
3Northwestern University, Chicago, IL
4Northwestern University, Chicago, IL
5Northwestern University, Chicago, IL

Meeting: Hospital Medicine 2010, April 8-11, Washington, D.C.

Abstract number: 80

Background:

In previous studies, type 2 diabetes mellitus (DM) has been associated with increased incidence of hospitalization for pneumonia as well as increased pneumonia‐associated morbidity and mortality. It is unknown if decreased lung diffusion capacity (DLCO) can predict hospitalization for pneumonia, independent of diabetes control, DM severity, and comorbidities.

Methods:

Using the electronic medical records from Northwestern Memorial Hospital's Enterprise Data Warehouse (EDW), we identified all adult patients who had pulmonary function tests (PFTs) performed between January 1, 2000, and May 1, 2009. From an initial sample of 26, 110 patients with complete PFTs, we excluded patients with multiple PFTs (we included only the most recent exam), those with a history of diseases that can affect lung function (respiratory, musculoskeletal, neuromuscular, rheumatic, vasculitis), patients with type 1 DM, and patients who lacked information on smoking history or race. The study population included 560 patients with DM and 3607 patients without DM. We used multiple linear regression to compare DLCO, forced expiratory volume in first second (FEV1) and forced vital capacity (FVC) in patients with DM and without DM, adjusting for covariates (age, sex, height, race, body mass index, smoking, heart failure). In secondary analyses, we included only patients with DM and compared the odds of being admitted due to pneumonia in patients with DLCO below versus above the mean, after adjusting for covariates (age, sex, height, race, body mass index, smoking, heart failure, DM control, DM severity, and renal disease).

Results:

Patients with DM had a mean age of 63 years, 44% were women, 65% were white, they had a mean BMI of 32 kg/m2, 27% were current smokers, and 33% had a history of heart failure. DM patients had significantly decreased DLCO (17 ± 0.22 vs. 15.7 ± 0.26 mL/min/mm Hg, P < 0.01), FEV1 (2.22 ± 0.02 vs. 2.14 ± 0.03 L, P < 0.01), and FVC (2.84 ± 0.03 vs. 2.68 ± 0.03 L, P < 0.01) compared with patients without DM. Diabetic patients with DLCO below the mean were 2.3 times more likely to be admitted for community‐acquired pneumonia compared with DLCO above the mean (multivariate adjusted odds ratio 2.28 with 95% confidence interval 1.05–5.15).

Conclusions:

Patients with DM have decreased lung function (DLCO, FEV1, and FVC) compared with those without diabetes. In diabetic patients, DLCO is a powerful independent predictor of hospitalizations for community‐acquired pneumonia, independent of blood glucose control and diabetes severity and other comorbidities.

Author Disclosure:

O. Klein, none; M. Tipping, none; J. Lee, none; J. Peng, none; M. Williams, none.

To cite this abstract:

Klein O, Tipping M, Lee J, Peng J, Williams M. Diffusion Lung Capacity Predicts Hospitalization for Pneumonia in Patients with Type 2 Diabetes Mellitus. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 80. Journal of Hospital Medicine. 2010; 5 (suppl 1). https://www.shmabstracts.com/abstract/diffusion-lung-capacity-predicts-hospitalization-for-pneumonia-in-patients-with-type-2-diabetes-mellitus/. Accessed November 14, 2019.

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