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Study on Appropriate Technology of Standardized Diagnosis and Treatment for Diabetic Patients With Pulmonary Infections

Conditions
Diabetes Mellitus
Pulmonary Infection
Registration Number
NCT03617393
Lead Sponsor
Ruijin Hospital
Brief Summary

Focusing on patients with diabetes complicated with pulmonary infection, the purpose of this study is: 1) to identify the epidemiology, etiologic spectrum and status of diagnosis and treatment; 2) to develop a symptom score scale , clarify the risk factors and create a precise warning model; 3) to develop a rapid detection of pathogen of lower respiratory infection, to establish clinical pathways of early diagnosis and treatment of diabetes complicated with pulmonary infections (including bacterial, tuberculosis and fungal infections) and then make an application in clinic.

Detailed Description

Investigators perform a observational study on 6000 patients with diabetes, among which 200 patients with pulmonary infection are included in a retrospective study and 100 patients go through metabolomics research. All patients receive clinical questionnaires, laboratory examinations and pulmonary function tests. Investigators study on pathogen distribution and infection ratio of patients above depending on follow-up survey. 1:1 nested case-control study is carried out involving 100 cases from pulmonary-infected group paired with 100 control cases matched for gender, age and fasting blood-glucose. The final purpose is to create a precise warning model in order to develop a rapid detection of pathogen of lower respiratory infection in diabetes patients. Now investigators wish to register this study to do a further research, in order to improve the early diagnosis of diabetes complicated with pulmonary infection and to reduce the mortality.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
6000
Inclusion Criteria
  • Diagnosis by pathogen examination: positive
  • Diagnosis through X-ray or CT: characteristic features of pulmonary infection
  • Diagnosis through guideline of diabetes or history of diagnosed diabetes
  • Age 40-70 years
Exclusion Criteria
  • Irregular follow-up and lost follow-up
  • Withdraw from the study for any reason

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Survival at 30 Days30 days from date of diagnosis of pulmonary infection until the date of death from any cause.

Accuracy and sensitivity of novel survival prediction algorithm derived from differences between the predicted and actual 30-day-survival of patients from different groups.

Survival at 90 Days90 days from date of diagnosis of pulmonary infection until the date of death from any cause.

Accuracy and sensitivity of novel survival prediction algorithm derived from differences between the predicted and actual 90-day-survival of patients from different groups.

Survival at 1 Year1 year from date of diagnosis of pulmonary infection until the date of death from any cause.

Accuracy and sensitivity of novel survival prediction algorithm derived from differences between the predicted and actual 1-year-survival of patients from different groups.

Secondary Outcome Measures
NameTimeMethod
Hospitalization TimeEvery 6 months from date of diagnosis of pulmonary infection until the date of death from any cause, assessed up to 3 years

Differences in the time of hospital stay including ordinary sickroom and ICU of patients from different groups.

SepsisEvery 6 months from date of diagnosis of pulmonary infection until the date of death from any cause, assessed up to 3 years

Differences in the primary and secondary sepsis after therapy according to guideline from different groups.

CURB-65 ScoreEvery 6 months from date of diagnosis of pulmonary infection until the date of death from any cause, assessed up to 3 years

Differences in confusion, urea, respiratory rate and age 65 scoring system from different groups.

Fungal Infection ExaminationsDay 0, day 3, day 10-14 and final result from date of diagnosis of pulmonary infection until the date of death or cure from any cause, assessed up to 1 years

Assessment of G test and GM test in order to clarify the diagnosis of fungal infection.

Cell-mediated Immunoserologic IndexsDay 0, day 3, day 10-14 and final result from date of diagnosis of pulmonary infection until the date of death or cure from any cause, assessed up to 1 years

Differences of CD3, CD4 and CD8 in different groups in order to research on cell-mediated immunity of patients with or without diabetes and pulmonary infection.

Inflammatory ParametersDay 0, day 3, day 10-14 and final result from date of diagnosis of pulmonary infection until the date of death or cure from any cause, assessed up to 1 years

Differences in CRP, PCT, IL-6, IL-8, TNF-α from different groups.

Cryptococcal Infection ExaminationsDay 0, day 3, day 10-14 and final result from date of diagnosis of pulmonary infection until the date of death or cure from any cause, assessed up to 1 years

Assessment latex agglutination test in order to clarify the cryptococcal infection.

Humoral Immunoserologic IndexesDay 0, day 3, day 10-14 and final result from date of diagnosis of pulmonary infection until the date of death or cure from any cause, assessed up to 1 years

Differences of IgG, IgA, IgE and IgM in different groups in order to research on cell-mediated immunity of patients with or without diabetes and pulmonary infection.

Trial Locations

Locations (1)

Ruijin Hospital Shanghai Jiao Tong University School of Medicine

🇨🇳

Shanghai, Shanghai, China

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