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已发表论文
糖尿病对脓毒症临床特征及预后的影响：一项回顾性研究
Received 20 June 2025
Accepted for publication 28 September 2025
Published 6 October 2025 Volume 2025:18 Pages 13823—13834
DOI https://doi.org/10.2147/JIR.S548570
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Anh Ngo
Wen-Wen Han, Jian-Jiang Fang
Department of Emergency, Ningbo Medical Center Lihuili Hospital, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang, People’s Republic of China
Correspondence: Jian-Jiang Fang, Department of Emergency, Ningbo Medical Center Lihuili Hospital, The Affiliated Lihuili Hospital of Ningbo University, No. 57 Xingning Road, Yinzhou District, Ningbo, Zhejiang, 315100, People’s Republic of China, Email JianJiangFang001@163.com
Background: Diabetes mellitus (DM) may alter the clinical trajectory of sepsis by modulating immune responses, infection patterns, and outcomes. This study aimed to assess the impact of diabetes on the clinical characteristics and prognosis of sepsis patients.
Methods: This retrospective included 256 adult sepsis patients admitted between January 2021 and December 2024. Based on diabetes status, patients were categorized into a diabetic group (n = 151) and a non-diabetic group (n = 105). Clinical features, laboratory parameters, infection types, and outcomes were compared. Prognostic factors in diabetic sepsis were assessed using Spearman correlation and logistic regression.
Results: Compared to non-diabetic patients, diabetic sepsis patients had higher rates of Escherichia coli infection (25.5% vs 10.6%, χ² = 8.450, p = 0.004), fungal co-infection (23.84% vs 5.71%, p = 0.004), and urinary tract infections (45.03% vs 30.48%). Diabetic patients also had elevated Acute Physiology and Chronic Health Evaluation II (APACHE II) scores (13.4 ± 6.5 vs 10.7 ± 4.4, t = 3.706, p < 0.001), C-reactive protein (CRP) levels (median 0.45 vs 0.37 mg/dL, Z = 4.506, p < 0.01), and procalcitonin (PCT) levels (median 7.9 vs 3.7 ng/mL, Z = 3.118, p < 0.05), along with increased mortality (25.83% vs 15.24%, χ² = 4.117, p < 0.05). Among diabetic patients, APACHE II score correlated with 28-day mortality (r = 0.463, p < 0.001) and was an independent predictor (OR = 1.177, 95% CI: 1.019– 1.361, p = 0.029), whereas CRP and PCT were not independently associated with prognosis (p > 0.05).
Conclusion: Diabetic sepsis patients showed distinct microbiological profiles, more urinary and fungal infections, and poorer outcomes. While the APACHE II score was independently associated with 28-day mortality, its moderate correlation suggests a multifactorial interplay. These results support the potential utility of integrated prognostic models combining clinical scores and biomarkers.
Keywords: diabetes mellitus, sepsis, APACHE II score, inflammatory markers, mortality, multiple organ dysfunction syndrome
Department of Emergency, Ningbo Medical Center Lihuili Hospital, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang, People’s Republic of China
Correspondence: Jian-Jiang Fang, Department of Emergency, Ningbo Medical Center Lihuili Hospital, The Affiliated Lihuili Hospital of Ningbo University, No. 57 Xingning Road, Yinzhou District, Ningbo, Zhejiang, 315100, People’s Republic of China, Email JianJiangFang001@163.com
Background: Diabetes mellitus (DM) may alter the clinical trajectory of sepsis by modulating immune responses, infection patterns, and outcomes. This study aimed to assess the impact of diabetes on the clinical characteristics and prognosis of sepsis patients.
Methods: This retrospective included 256 adult sepsis patients admitted between January 2021 and December 2024. Based on diabetes status, patients were categorized into a diabetic group (n = 151) and a non-diabetic group (n = 105). Clinical features, laboratory parameters, infection types, and outcomes were compared. Prognostic factors in diabetic sepsis were assessed using Spearman correlation and logistic regression.
Results: Compared to non-diabetic patients, diabetic sepsis patients had higher rates of Escherichia coli infection (25.5% vs 10.6%, χ² = 8.450, p = 0.004), fungal co-infection (23.84% vs 5.71%, p = 0.004), and urinary tract infections (45.03% vs 30.48%). Diabetic patients also had elevated Acute Physiology and Chronic Health Evaluation II (APACHE II) scores (13.4 ± 6.5 vs 10.7 ± 4.4, t = 3.706, p < 0.001), C-reactive protein (CRP) levels (median 0.45 vs 0.37 mg/dL, Z = 4.506, p < 0.01), and procalcitonin (PCT) levels (median 7.9 vs 3.7 ng/mL, Z = 3.118, p < 0.05), along with increased mortality (25.83% vs 15.24%, χ² = 4.117, p < 0.05). Among diabetic patients, APACHE II score correlated with 28-day mortality (r = 0.463, p < 0.001) and was an independent predictor (OR = 1.177, 95% CI: 1.019– 1.361, p = 0.029), whereas CRP and PCT were not independently associated with prognosis (p > 0.05).
Conclusion: Diabetic sepsis patients showed distinct microbiological profiles, more urinary and fungal infections, and poorer outcomes. While the APACHE II score was independently associated with 28-day mortality, its moderate correlation suggests a multifactorial interplay. These results support the potential utility of integrated prognostic models combining clinical scores and biomarkers.
Keywords: diabetes mellitus, sepsis, APACHE II score, inflammatory markers, mortality, multiple organ dysfunction syndrome