Sex Differences in Hospital-Acquired Pneumonia among Patients with Type 2 Diabetes Mellitus Patients: Retrospective Cohort Study using Hospital Discharge Data in Spain (2016–2019)

Ana Lopez- de-Andres, Marta Lopez-Herranz, Valentin Hernandez-Barrera, Javier de-Miguel-Diez, Jose M. de-Miguel-Yanes, David Carabantes-Alarcon, Romana Albaladejo-Vicente, Rosa Villanueva-Orbaiz and Rodrigo Jimenez-Garcia
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Ana Lopez- de-Andres: Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
Marta Lopez-Herranz: Physiotherapy and Podology Nursing Department, Faculty of Nursing, Universidad Complutense de Madrid, 28040 Madrid, Spain
Valentin Hernandez-Barrera: Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, 28922 Madrid, Spain
Javier de-Miguel-Diez: Respiratory Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, 28040 Madrid, Spain
Jose M. de-Miguel-Yanes: Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, 28040 Madrid, Spain
David Carabantes-Alarcon: Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
Romana Albaladejo-Vicente: Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
Rosa Villanueva-Orbaiz: Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
Rodrigo Jimenez-Garcia: Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain

IJERPH, 2021, vol. 18, issue 23, 1-15

Abstract: (1) Background: To analyze the incidence, clinical characteristics, use of procedures, and in-hospital outcomes in patients who developed pneumonia during their hospital admission according to sex and to the presence of type 2 diabetes mellitus (T2DM). (2) Methods: Retrospective cohort study using data from the Spanish National Hospital Discharge Database. Hospital-acquired pneumonia (HAP) was classed as non-ventilator HAP and ventilator-associated pneumonia (VAP). Separate analyses were performed for men and women with and without T2DM. Population subgroups were compared using propensity score matching. (3) Results: HAP was identified in 38,814 patients (24.07% with T2DM). The adjusted incidence of HAP was higher in patients with T2DM (both sexes) (IRR 1.28; 95% CI 1.25–1.31). The incidence of HAP was higher in men with T2DM than in women with T2DM (adjusted-IR 1.47; 95% CI 1.41–1.53). The incidence of HAP among T2DM patients increased over time. In-hospital mortality (IHM) was around 28% irrespective of T2DM status and sex. After adjusting for confounders and sex, VAP was associated to higher IHM among patients with T2DM (OR 2.09; 95% CI 1.7–2.57). (4) Conclusions: T2DM is associated with a higher risk of HAP, whose incidence increased over time. Men with T2DM have an almost 50% higher risk of HAP than women with T2DM. The probability of dying in the hospital was not associated with sex or T2DM.

Keywords: hospital-acquired pneumonia; ventilator-associated pneumonia; type 2 diabetes mellitus; hospitalizations; sex differences; outcomes (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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