Population-based cohort study investigating the correlation of diabetes mellitus with pleural empyema in adults in Taiwan

Abstract

We assessed the association between diabetes mellitus and the risk of pleural empyema in Taiwan.A population-based retrospective cohort study was conducted using the database of the Taiwan National Health Insurance Program. There were 28,802 subjects aged 20 to 84 years who were newly diagnosed with diabetes mellitus from 2000 to 2010 as the diabetes group and 114,916 randomly selected subjects without diabetes mellitus as the non-diabetes group. The diabetes group and the non-diabetes group were matched by sex, age, comorbidities, and the year of index date. The incidence of pleural empyema at the end of 2011 was estimated. A multivariable Cox proportional hazards regression model was used to estimate the hazard ratio (HR) and 95% confidence interval (95% CI) for pleural empyema associated with diabetes mellitus.The overall incidence of pleural empyema was 1.65-fold higher in the diabetes group than that in the non-diabetes group (1.58 vs 0.96 per 10,000 person-years, 95% CI 1.57-1.72). After adjusting for confounders, a multivariable Cox proportional hazards regression model revealed that the adjusted HR of pleural empyema was 1.71 in subjects with diabetes mellitus (95% CI 1.16-2.51), compared with those without diabetes mellitus. In further analysis, even in the absence of any comorbidity, the adjusted HR was 1.99 for subjects with diabetes mellitus alone (95% CI 1.18-3.38).Diabetic patients confer a 1.71-fold increased hazard of developing pleural empyema. Even in the absence of any comorbidity, the risk remains existent.

An acute foreign body ingestion presenting as left sided empyema as its removal by novel method

“…It may be because our patient was having diabetes which has been shown independent risk factor in diabetes [9].…”

“…Empyema following aspiration of a FB is rare scenario which has never been reported in literature in adults. One study which was done over a period of 15 year revealed among 1038 patients of bronchiectasis only eight were found to be due to a long retained FB [9]. It has been proven again and again that removal of FB is suffi cient to revert the lung changes to normal, and usually it does not warrant any surgical intervention but at times need lobectomy or even pneumectomy [10].…”

Clinical characteristics and related factors of fungal empyema thoracis

“…Patients with diabetes mellitus were proven to have increased respiratory infectious risk due to inadequate clearance or the disturbance of normal pulmonary immune function [20]. It has been reported that diabetic patients conferred a 1.71-fold increased risk of empyema thoracis without any comorbidity [21]. A series of retrospective studies showed that the hazard of developing empyema was higher for patient with diabetes mellitus than those with chronic obstructive lung disease or chronic liver disease and cirrhosis [20,22].…”

Association between diabetes mellitus and infection : which evidence for a causal role of hyperglycemia ?

“…L'association entre l'incidence de la pneumonie communautaire et le diabète est retrouvée dans la plupart des études (mais pas toutes). Il est également lié à une augmentation de complications de cette pneumonie (bactériémie, empyème, décès) [22][23][24][25][26][27][28][29][30][31][32][33][34] .…”