A Nationwide Analysis of Diabetes Mellitus and Intracranial Injuries: No Impact on Mortality but Prolonged Hospital Stays in Germany

Abstract

Background and Objectives: Diabetes mellitus (DM) is a growing global health concern linked to increased hospitalization rates, longer hospital stays, and higher mortality. Older adults with DM are particularly prone to intracranial injuries due to frailty and DM-related complications such as neuropathy and cardiovascular diseases. This study explores the impact of DM on in-hospital outcomes in patients with intracranial injuries. Material and Methods: This retrospective cohort study used data from 45 hospitals in Germany, including 12,720 patients aged ≥40 years hospitalized between January 2019 and December 2023 with a primary diagnosis of intracranial injury. Patients were categorized based on the secondary presence of DM diagnosis (ICD-10 E10-E14). Outcomes included in-hospital mortality, rehospitalization within 1 year and hospital length of stay (LOS). Multivariable logistic regression models were used to analyze associations between DM and the different outcomes, adjusting for age, sex, hospitalization year, and comorbidities. Results: Among 12,720 patients, 2394 had a known DM diagnosis. The median age was higher in DM patients (82 vs. 79 years). In-hospital mortality rates were similar for patients with and without DM (4.7% vs. 4.6%; OR: 0.98; 95% CI: 0.78–1.22). DM was not associated with rehospitalization risk (OR: 1.06; 95% CI: 0.89–1.26) but showed a trend toward longer hospital stays (≥7 days: OR: 1.13; 95% CI: 1.01–1.26). Conclusions: While DM did not significantly influence mortality or rehospitalization after intracranial injuries, it showed a non-significant trend towards extended LOS (≥7 days). These findings underscore the importance of targeted management strategies to optimize outcomes in this population.

Affiliated Institutions

• University of Duisburg-Essen DE
• Philipps University of Marburg DE

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