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The Performance Of Curb-65 And Psi For Predicting In-Hospital Mortality Of Community-Acquired Pneumonia In Patients With Type 2 Diabetes Compared With The Non-Diabetic Population

DIABETES METABOLIC SYNDROME AND OBESITY-TARGETS AND THERAPY(2021)

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Abstract
Objective: To compare the performance of CURB-65 and Pneumonia Severity Index (PSI) for predicting in-hospital mortality of community-acquired pneumonia (CAP) between patients with and without type 2 diabetes (T2DM).Methods: A retrospective study was conducted on 2365 CAP patients in The First Hospital of Qinhuangdao, China. The primary outcome was in-hospital mortality. The area under curves (AUCs) was used to evaluate the abilities of CRB-65, CURB-65, and PSI class for predicting in-hospital mortality in patients with CAP.Results: Among CAP patients, 127 patients (5.4%) died, 80 patients were without diabetes, and 47 patients had T2DM. In-hospital mortality increased with the risk stratification defined as CURB-65 and PSI class in both non-diabetes and T2DM patients (P<0.05). The AUCs for predicting in-hospital mortality were 0.728 similar to 0.798 in patients without T2DM (CRB-65: 0.728, CURB-65: 0.757 and PSI class: 0.798) and 0.641 similar to 0.716 in patients with T2DM (CRB-65: 0.641, CURB-65: 0.677 and PSI class: 0.716)(P<0.001). The AUC of the PSI class was lower in patients with T2DM than in patients without T2DM (P<0.05). Conclusion: CURB-65 and PSI class are correlated with in-hospital mortality of CAP in patients with and without T2DM.Compared with non-diabetes patients, the predictive performance of CURB-65 and PSI class decreased in patients with T2DM. A prediction model for evaluating the CAP severity in the T2DM population should be developed by future studies.
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Key words
community-acquired pneumonia, CURB-65, pneumonia severity index, mortality, type 2 diabetes
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