title: Impact of diabetes on mortality among patients with community-acquired bacteremia.
abstract: OBJECTIVE
  To assess the impact of diabetes on 30-day mortality in patients with community-acquired bacteremia
  
  
  METHODS
  We conducted a hospital-based observational study in patients with community-acquired bacteremia who were admitted from the emergency department (ED). Consecutive admitted patients with positive blood cultures obtained in the ED were interviewed and their charts were reviewed. We compared 30-day mortality in diabetic patients with nondiabetic patients. Cox proportional hazards regression was used to estimate the independent effect of diabetes on 30-day mortality.
  
  
  RESULTS
  Among 839 patients in this study, 242 (29%) had diabetes. The median age of these patients was 67 years (interquartile range: 53-77) and 48% were women. The probability of survival at 30 days was not different between the diabetic and the nondiabetic group (84% vs. 77%, respectively; P=0.15 by Wilcoxon test). On multivariate analysis, diabetes was not associated with an increased risk of 30-day mortality (hazard ratio, 0.82; 95% confidence interval, 0.53-1.26). By contrast, age and higher comorbidity index increased the risk of 30-day mortality. Several markers of disease severity at ED presentation (tachycardia, hypotension, and bandemia) predict 30-day mortality.
  
  
  CONCLUSIONS
  Diabetes appears not to have significant impact on 30-day mortality in this study population. This finding should be interpreted in the context that diabetes patients may have an increased incidence of bacteremia.
authors.affiliation: Department of Emergency Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 100, Taiwan.
authors.forename: Chu-Lin
authors.initials: CL
authors.lastname: Tsai
authors.forename: Chien-Chang
authors.initials: CC
authors.lastname: Lee
authors.forename: Matthew Huei-Ming
authors.initials: MH
authors.lastname: Ma
authors.forename: Cheng-Chung
authors.initials: CC
authors.lastname: Fang
authors.forename: Shey-Ying
authors.initials: SY
authors.lastname: Chen
authors.forename: Wen-Jone
authors.initials: WJ
authors.lastname: Chen
authors.forename: Shan-Chwen
authors.initials: SC
authors.lastname: Chang
authors.forename: Shruti H
authors.initials: SH
authors.lastname: Mehta
mesh_terms: D000368:Aged; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality*; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality*; D048909:Diabetes Complications / Q000453:epidemiology / Q000401:mortality*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006095:Gram-Positive Cocci / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D016019:Survival Analysis; D015996:Survival Rate