Risk prediction of in-hospital mortality among patients with type 2 diabetes mellitus and concomitant community-acquired pneumonia

Background: The aim of the present study was to investigate the risk factors for in-hospital mortality among patients with type 2 diabetes mellitus (T2DM) and concomitant community-acquired pneumonia (CAP) and establish a risk prediction score. Methods: Data from 1,360 adult patients with T2DM and concomitant CAP hospitalized in two grade 3A hospitals between 2009 and 2019 were collected through electronic medical records. Data obtained included the status of diabetes mellitus, comorbidities, laboratory and imaging findings, and treatment outcomes. Statistical analysis was conducted to investigate the risk factors affecting prognosis, and a clinical risk prediction score was designed. Results: Based on the patients' treatment outcomes (deceased, improved and cured), the cohort was divided into two groups: deceased and improved; 16 parameters were significant after segmentation. However, the following nine parameters were independent predictors of mortality: neutrophil-lymphocyte ratio (NLR) >= 4, pulse rate >= 125 bpm, change in state of consciousness, arterial blood pH = 65 years, serum sodium = 9 mmol/L, multilobar involvement, and diabetic nephropathy. Based on these findings, a risk prediction score was established, and bootstrap validation was performed. The risk prediction score was significantly superior to CURB-65 [confusion, urea >7 mmol/L, respiratory rate >30/min, low blood pressure (systolic