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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

Authors Ma CM, Wang N, Su QW, Yan Y, Yin FZ

Received 21 January 2021

Accepted for publication 8 March 2021

Published 23 March 2021 Volume 2021:14 Pages 1359—1366


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Professor Ming-Hui Zou

Chun-Ming Ma, 1 Ning Wang, 2 Quan-Wei Su, 3 Ying Yan, 3 Fu-Zai Yin 1

1Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, People’s Republic of China; 2Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China; 3Department of Internal Medicine, Chengde Medical College, Chengde, Hebei, People’s Republic of China

Correspondence: Fu-Zai Yin Email [email protected]

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 0.728~0.798 in patients without T2DM (CRB-65: 0.728, CURB-65: 0.757 and PSI class: 0.798) and 0.641~0.716 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.

Keywords: community-acquired pneumonia, CURB-65, pneumonia severity index, mortality, type 2 diabetes

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