Glycated haemoglobin A1c predicts the mortality risk in patients with influenza pneumonia
Objective To investigate whether glycated haemoglobin A1c(HbA1c)can be used as a predictor of mortality risk in patients with influenza pneumonia.Methods This study was a single-center retrospective study,and enrolled patients with influenza pneumonia in the Emergency Department and in-patient departments of Beijing Chaoyang Hospital,Capital Medical University from 2017 to 2019.Gender,age,underlying diseases,influenza virus nucleic acid or antigen results,chest X-ray or chest CT reports,routine blood test,biochemical indicators,HbA1c and procalcitonin(PCT)were collected,and all subjects were divided into survival and death groups based on 28-day mortality.The differences between the two groups were compared and Cox regression was used to analyze risk factors for 28-day mortality.Results In this study,122 patients with influenza pneumonia were included,and 94(77.0％)cases were divided into the survival group and 28(23.0％)cases into the death group.Univariate analysis showed that lymphocyte counts[0.49(0.33,0.73)vs.0.77(0.49,1.23)×109/L,Z=-3.008,P=0.003]were lower and HbA1c levels[6.5(6.1,7.1)vs.6.1(5.7,6.8)％,Z=2.203,P=0.028]and PCT levels[0.64(0.20,6.43)vs.0.16(0.05,0.87)μg/L,Z=2.594,P=0.009]were higher in dead patients compared with those in the survivors.Cox multivariate regression and survival analysis found that after adjusting for age,lymphocyte counts(HR=0.260,95％CI:0.087-0.773,P=0.015)and HbA1c levels(HR=1.295,95％CI:1.007-1.666,P=0.044)were independent risk factors for 28-day mortality.Conclusions HbA1c is an independent risk factor for predicting 28-day mortality in patients with influenza pneumonia.
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