Gadsby-Davis Kieran, Garner Nikki, Ergin Busra Donat, Dhatariya Ketan, Hornberger Michael
Norwich Medical School, University of East Anglia, Norwich Research Park, NR4 7TJ, UK.
Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich, UK.
Diabetes Ther. 2025 Jan;16(1):103-120. doi: 10.1007/s13300-024-01672-w. Epub 2024 Nov 28.
Previous reviews have demonstrated that dementia and diabetes mellitus, separately, can worsen the hospital outcomes of patients. Unfortunately, there are no systematic evaluations regarding the hospital outcomes of patients with dementia and diabetes mellitus as a comorbidity. Therefore, our review aimed to determine any differences in hospital length of stay, hospital mortality, and hospital readmission between patients with the comorbidity and patients without.
Searches were conducted of Medline, CINHAL, EMBASE, PsychINFO, Web of Science and Google Scholar for original studies. All studies were quality assessed using the Joanna Briggs Institute critical appraisal tools. Where possible, studies were pooled in a meta-analysis to generate odds ratios (OR) with 95% confidence intervals (CI).
Sixteen studies were included in this review. When comparing patients with the comorbidity to patients with dementia, the difference in length of stay was inconclusive, and there was no difference in the odds of hospital mortality (OR = 0.98, 95% CI 0.91-1.06). However, patients with the comorbidity had increased odds of 30-day readmission compared to patients with dementia alone (OR = 1.20, 95% CI 1.14-1.26). When comparing patients with the comorbidity to patients with diabetes, those with the comorbidity had a longer length of stay and but no difference in the odds of hospital mortality (OR = 1.48, 95% CI 0.84-2.62). Additionally, those with the comorbidity may have worse readmission outcomes than those with diabetes alone.
Our findings suggest that patients with comorbid dementia and diabetes mellitus may have worse hospital outcomes. Therefore, we recommend further research to assess these patients' hospital outcomes to resolve the discrepancies found.
以往的综述表明，痴呆症和糖尿病各自都会使患者的住院结局恶化。遗憾的是，目前尚无关于痴呆症和糖尿病合并症患者住院结局的系统评估。因此，我们的综述旨在确定合并症患者与非合并症患者在住院时间、住院死亡率和再次入院率方面是否存在差异。
检索了Medline、CINHAL、EMBASE、PsychINFO、科学网和谷歌学术等数据库中的原始研究。所有研究均使用乔安娜·布里格斯研究所的批判性评价工具进行质量评估。在可能的情况下，将研究纳入荟萃分析以生成比值比（OR）及95%置信区间（CI）。
本综述纳入了16项研究。将合并症患者与痴呆症患者进行比较时，住院时间差异尚无定论，住院死亡率的比值比无差异（OR = 0.98，95% CI 0.91 - 1.06）。然而，与单纯痴呆症患者相比，合并症患者30天再次入院的几率增加（OR = 1.20，95% CI 1.14 - 1.26）。将合并症患者与糖尿病患者进行比较时，合并症患者的住院时间更长，但住院死亡率的比值比无差异（OR = 1.48，95% CI 0.84 - 2.62）。此外，合并症患者的再次入院结局可能比单纯糖尿病患者更差。
我们的研究结果表明，痴呆症和糖尿病合并症患者的住院结局可能更差。因此，我们建议进一步开展研究以评估这些患者的住院结局，以解决所发现的差异。
