Risk Factors And Prediction Model For In-hospital Mortality In Patients With Pulmonary Infection And Type 2 Diabetes Requiring Mechanical Ventilation Suppor

Objective:With a high incidence of pneumonia,low early diagnosis rate,low disease control rate,low pathogen detection rate,and high case fatality rate in Chinese patients with diabetes mellitus,the accuracy and applicability of CURB-65 score and pulmonary infection Severity Index(PSI)scoring system in clinical patients with T2DM are reduced.The objective of this study was to investigate the risk factors associated with in-hospital death in patients with pulmonary infection and type 2 diabetes requiring mechanical ventilation support and to construct a graph.Methods:A single-center retrospective study(Jan.1,2015,to Dec.31,2020)was conducted to analyze the patients with pulmonary infection complicated with type 2 diabetes requiring mechanical ventilation in Peking Union Medical College Hospital.The main outcome was hospital death and death.The independent risk factors were determined by univariate logistic regression analysis and multivariate logistic regression analysis.The multivariate logistic regression analysis model was used to construct the scoring model,and the decision curve analysis(DCA)curve and clinical decision curve were drawn.Results:A total of 2132 patients with pulmonary infection requiring mechanical ventilation were selected from the inpatient medical record system,and 403 of them were complicated with type 2 diabetes.According to the patient’s treatment results(death,improvement,and cure),403 patients were divided into two groups:death group and survival group;After grouping,18 parameters were found to be statistically significant.Four parameters were independent predictors of mortality by multiple factors,including age,concomitant shock,and maximum creatinine and prothrombin time detected during treatment.Based on these variables,a risk prediction score was established.ROC=0.821 95%CI:0.768-0.874.Conclusions:In this study,we found that increasing age,hemodynamic instability,increased creatinine,and prothrombin duration were independent risk factors and predictors of in-hospital death in patients with pulmonary infection and type 2 diabetes requiring mechanical ventilation.The scoring model developed in this study was used to clarify the clinical characteristics of patients with pulmonary infection complicated with type 2 diabetes requiring mechanical ventilation support,to help clinically identify highrisk patients and predict the outcome of patients.