Yo et al identified risk factors for mortality in a patient with type 2 diabetes mellitus and community-acquired bloodstream infection. This can help to identify a patient who may benefit from more aggressive management. The authors are from Far Eastern Hospital (Taiwan), National Taiwan University, Heidelberg University, and Chang Gung University.
Patient selection: type 2 diabetes mellitus and community-acquired bloodstream infection
Outcome: 30-day mortality
Risk factors for 30-day mortality from multivariate analysis:
(1) chronic corticosteroid therapy (odds ratio 3.9)
(2) diabetic ketoacidosis (odds ratio 3.8)
(3) Charlson comorbidity score >= 6 (odds ratio 2.5)
(4) therapy with inappropriate antibiotics (odds ratio 2.3)
(5) sepsis classification as septic shock, severe sepsis or systemic inflammatory response syndrome (SIRS) versus simple bloodstream infection (odds ratio 2.3)
Interpretation:
• The minimum number of risk factors is 0.
• The maximum number of risk factors is 5.
• The risk of 30-day mortality increases with the number of risk factors present.
Other risk factors from univariate analysis:
(1) higher glycated hemoglobin (poor diabetes control)
(2) underlying malignancy
(3) lower respiratory tract infection
