アブストラクト | BACKGROUND: Sodium-glucose co-transporter-2 inhibitors (SGLT2i) may contribute to better clinical outcomes in adults with diabetes and pneumonia owing to their potential anti-inflammatory effects. To investigate whether SGLT2i are associated with lower in-hospital mortality following pneumonia without heart failure than dipeptidyl peptidase-4 inhibitors (DPP-4i). METHODS: Using the Japanese Diagnosis Procedure Combination database, we retrospectively identified patients with diabetes aged >/=65 years treated with SGLT2i or DPP-4i who were admitted and managed for pneumonia from April 2016 to October 2020. We then compared in-hospital mortality, the need for mechanical ventilation, and discharges to locations (other than home) between the SGLT2i and DPP-4i groups using multivariable logistic regression analyses fitted with generalized estimating equations. RESULTS: We analyzed the data of 27,334 patients (mean age, 78.8 years; male, 71.2%), including 535 and 26,799 patients regularly treated with SGLT2i and DPP-4i, respectively. No significant differences were observed between the SGLT2i and DPP-4i groups in in-hospital mortality rate (3.4% vs. 5.9%; odds ratio [OR], 0.64; 95% confidence interval [CI], 0.40-1.05), the need for mechanical ventilation (1.5% vs. 1.8%; OR, 0.78; 95%Cl, 0.39-1.59), and discharge to locations other than home (8.1% vs. 14.1%; OR, 0.72; 95%Cl, 0.51-1.02). The association between the diabetic treatment and in-hospital mortality remained insignificant across weight subgroups (underweight: OR, 0.47; 95%Cl, 0.13-1.67; normal weight: OR, 0.66; 95%Cl, 0.34-1.25; and overweight/obesity: OR 1.06; 95%Cl, 0.43-2.65). CONCLUSIONS: Regular SGLT2i use in patients with diabetes admitted with pneumonia without heart failure may not be associated with improved in-hospital mortality outcomes compared with DPP-4i use. |
ジャーナル名 | Respiratory investigation |
Pubmed追加日 | 2024/12/12 |
投稿者 | Maki, Hiroki; Isogai, Toshiaki; Michihata, Nobuaki; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo |
組織名 | Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan; Department of Pharmacy, Kofu City;Regional Medical Center, Yamanashi, Japan. Electronic address:;makih1210@gmail.com.;Health, The University of Tokyo, Tokyo, Japan; Department of Cardiology, Tokyo;Metropolitan Tama Medical Center, Tokyo, Japan.;Health, The University of Tokyo, Tokyo, Japan; Cancer Prevention Center, Chiba;Cancer Center Research Institute, Chiba, Japan.;Department of Health Services Research, Graduate School of Medicine, The;University of Tokyo, Tokyo, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School of Medicine and Dental Science, Tokyo, Japan.;Health, The University of Tokyo, Tokyo, Japan. |
Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/39662122/ |