1075. Mortality of Community-Acquired Pneumonia in Elderly Patients with Diabetes Mellitus
Session: Poster Abstract Session: Infection in Immunocompromised Patients
Saturday, October 22, 2011
Room: Poster Hall B1
Background:  Studies have found that both diabetic and elderly patients with community-acquired pneumonia (CAP) had a poor prognosis, more invasive disease, more complications, and increased mortality. Timely administration of effective antibiotic was associated with decreased mortality in patients with CAP. The primary objective of our study is to determine if late administration of appropriate antibiotic after 8 hours of triage is associated with increased mortality of CAP in elderly patients with diabetes

Methods:  This is a retrospective cohort study of elderly diabetic patients who were admitted with CAP. The primary outcome is in hospital mortality. A stepwise logistic regression analysis was performed to determine predictors of mortality of CAP.     

Results:  

There were 165 elderly diabetic patients admitted for CAP. 30(18%) patients died before discharge. Thirteen of 121 patients who received their first appropriate antibiotics in less than 8 hours after triage died (10.7%), while 17 of 44 patients who received their first appropriate antibiotics longer than 8 hours after triage died (38.6%) (P= <.0001). Multivariate analysis identified that administration of appropriate antibiotic therapy longer than 8 hours after triage as the only factor associated with increased mortality (OR 2.3, P=0.05, 95% CI :1.1-5.2). Severity of pneumonia measured by port was not associated with increased mortality in the multivariate analysis (P=0.3).

Conclusion: CAP is associated with a high rate of mortality even with appropriate antibiotic therapy. Late administration of first dose of appropriate antibiotic is associated with increased mortality. Efforts should be made to delivery appropriate antibiotic as early as possible to elderly patients with CAP and diabetes.


Subject Category: C. Clinical studies of bacterial infections and antibacterials including sexually transmitted diseases and mycobacterial infections (surveys, epidemiology, and clinical trials)

Mazen Bader, md, Department of Medicine, division of Infectious Diseases, Mcmaster University, Hamilton, ON, Canada and Yanqing Yi, phd, Memorial University of Newfoundland, St. John's, NL, Canada

Disclosures:

M. Bader, None

Y. Yi, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.