Objective: To assess the impact of blood glucose levels on the prognosis of patients with community-acquired pneumonia (CAP) who were elderly or middle-aged.
Methods: From January 1, 2018, to December 31, 2020, patients with CAP (≥ 45 years) were retrospectively enrolled in this observational study. They were stratified by age (45– 64 or ≥ 65 years) and blood glucose level (≥ 11.1 or < 11.1 mmol/l). The effect of admission blood glucose on 28-day mortality was assessed with the Cox proportional hazards model, adjusted for demographic factors and comorbidity.
Results: Among 1656 patients with CAP, increased blood glucose (HR=2.08, 95% CI: 1.38– 3.49; P < 0.01) and advanced age (HR=2.76, 95% CI: 1.65– 3.77; P < 0.01) were significantly associated with a higher risk of 28-day mortality, after controlling for potential confounding factors. The strength of the association of blood glucose level with 28-day mortality decreased with age (P =0.01 for the interaction) as the adjusted HRs for death were 4.48 (95% CI: 1.40– 13.65; P < 0.01) for middle-age patients 45– 64 years and 1.52 (95% CI: 1.09– 2.17; P =0.05) for elderly patients ≥ 65 years.
Conclusion: The association of blood glucose level upon admission for CAP with all-cause mortality was stronger at younger ages.
Keywords: age, community-acquired pneumonia, hyperglycemia, mortality, prognosis