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Do admission glucose levels aid in predicting mortality associated with community-acquired pneumonia?

Douwe F. Postma, Cornelis H. van Werkhoven, Darren P.R. Troeman, Sanjay U.C. Sankatsing, Jan Jelrik Oosterheert, Marc J.M. Bonten
European Respiratory Journal 2017 50: 1700307; DOI: 10.1183/13993003.00307-2017
Douwe F. Postma
1Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
2Dept of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
3Dept of Internal Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands
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  • For correspondence: d.f.postma@umcutrecht.nl
Cornelis H. van Werkhoven
1Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
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Darren P.R. Troeman
1Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
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Sanjay U.C. Sankatsing
3Dept of Internal Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands
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Jan Jelrik Oosterheert
2Dept of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
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Marc J.M. Bonten
1Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
4Dept of Medical Microbiology, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
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Tables

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  • TABLE 1

    Model-based estimates for 30-day mortality in reference to categories of admission glucose levels

    Non-fasting AGL mmol·L−1PatientsRef. valueBivariate analysis (Model A)Adjusted for PSI
    score (Model B)
    Adjusted for
    CURB-65 score
    (Model C)
    At risk nDied n (%)
    4–<6 31722 (6.9)52.15 (1.42–3.24)1.94 (1.25–3.02)2.07 (1.34–3.19)
    6–<8 73338 (5.2)7Ref.
    8–<10 27710 (3.6)91.29 (1.09–1.54)1.08 (0.91–1.27)1.10 (0.94–1.29)
    10–<12 988 (8.2)111.84 (1.33–2.54)1.33 (0.97–1.81)1.40 (1.04–1.90)
    12–<14 525 (9.6)132.49 (1.60–3.88)1.66 (1.06–2.59)1.81 (1.18–2.78)
    ≥14 7212 (16.7)153.19 (1.86–5.45)2.03 (1.15–3.56)2.28 (1.32–3.93)

    Data in the first two columns are from a single imputation dataset. Model-based estimates of ORs (95% CIs) for 30-day mortality for several admission glucose level (AGL) categories. ORs were calculated for reference (Ref.) values in the centre of categories. Model A is for a second-degree polynomial fit of AGL only. Models B and C are the adjusted models with pneumonia severity index (PSI) and CURB-65 scores (confusion, urea >7 mmol·L−1, respiratory rate ≥30 breaths·min−1, blood pressure <90 mmHg (systolic) or ≤60 mmHg (diastolic), age ≥65 years), respectively. Formulas for the final logistic regression models, in which x denotes admission glucose level, β denotes model betas for CURB-65 categories, and z denotes PSI score, were as follows. Model A: Embedded Image. Model B: Embedded Image. Model C: Embedded Image. Model C betas were 0.92(CURB 65 score 1), 1.63(CURB 65 score 2), 2.42(CURB 65 score 3), 1.88(CURB 65 score 4) and 3.17(CURB 65 score 5).

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      C.H. van Werkhoven ERJ-00307-2017_van-Werkhoven

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    Do admission glucose levels aid in predicting mortality associated with community-acquired pneumonia?
    Douwe F. Postma, Cornelis H. van Werkhoven, Darren P.R. Troeman, Sanjay U.C. Sankatsing, Jan Jelrik Oosterheert, Marc J.M. Bonten
    European Respiratory Journal Oct 2017, 50 (4) 1700307; DOI: 10.1183/13993003.00307-2017

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    Do admission glucose levels aid in predicting mortality associated with community-acquired pneumonia?
    Douwe F. Postma, Cornelis H. van Werkhoven, Darren P.R. Troeman, Sanjay U.C. Sankatsing, Jan Jelrik Oosterheert, Marc J.M. Bonten
    European Respiratory Journal Oct 2017, 50 (4) 1700307; DOI: 10.1183/13993003.00307-2017
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