Older Patients with Advanced Cirrhosis and Uncontrolled Diabetes Mellitus Have Higher Risk of Infections, Study Finds

A recent study has discovered that patients with advanced cirrhosis, uncontrolled diabetes mellitus (DM) seems to increase the risk of infections. Coupled with old age, the conditions also affect the survival outlook.

Photo: Diabetes Mellitus in Elderly People | InStyleHealth


Generating from the National Inpatient Sample of the USA, the researchers identified 3,104,310 patients with advanced cirrhosis, of whom 29.2% were diagnosed with diabetes mellitus and subsequently covered in the current study. The main result of interest was bacterial infection, while mortality among the elderly was set as a secondary conclusion.

Collective data from 1998 to 2014 shows the prevalence of DM increased from 21.3% to 38.4%. Meanwhile, the rate of uncontrolled DM increased from 16.2% to 9.4% in 2004, prior rising slightly back to 13.2% by 2014; the annual percentage change of uncontrolled DM was -0.1%.

In general, 29.1% of participants had bacterial infections, which was significantly prevalent among those with versus without uncontrolled diabetes mellitus (DM), 34.2% vs 28.4%. There were multiple infections occurred significantly more frequent among those with uncontrolled DM, 9% vs 6.3% respectively.

Using the multivariable logistic regression analysis, it was found out that uncontrolled DM increase the risk of bacterial infections by more than 30%. While in a sub-analysis of 243,864 elderly patients, the researchers discovered that while uncontrolled DM was rarer, 8.9% vs 13.3%, bacterial infections were much more prevalent.

Unfortunately, combination of old age and uncontrolled DM heightens the possibility of bacterial infections by over 40%, and of all-cause mortality by more than 60%.

 

Source: Dig Liver Dis 2021;53:445-451

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