Patients with diabetes are at a higher risk of mortality when discharged from hospital, a recent study published in the Journal of Diabetes and its complications concludes. The authors, Teesta Mukherjee (Institute of Digital Healthcare, WMG, University of Warwick, Coventry, UK) and colleagues, have identified 48 risk factors, ranging from body mass index (BMI) to age to comorbidities, from a number of scientific papers that they say should be considered when discharging diabetic patients.
“A relatively small number of studies have considered risk factors relating to mortality for patients discharged from hospital with a diagnosis of diabetes,” they write. “Mortality is an important outcome, when considering discharge from hospital with diabetes. However, there has only been limited consideration within the research literature.”
When patients are discharged from hospital, those with diabetes are at an increased risk of readmission and mortality, Mukherjee et al found. There are guidelines for discharging patients with diabetes to reduce these risks, however the investigators have identified known risk factors for mortality in adult patients discharged from hospital with diabetes.
The researchers identified 35 studies that considered the risk factors relating to mortality for patients discharged from hospital with diabetes through searching the EMBASE and MEDLINE databases. The inclusion criteria were papers that were published over the last six years, in English, and focused on the risk factors of mortality in adult patients with diabetes after they were discharged from hospitals. This was followed by data extraction, “with quality assessment and semi-quantitative synthesis according to PRISMA guidelines”. Analysis of these studies identified 48 significant risk factors for mortality.
The 48 risk factors are grouped into the following nine categories:
- Patient medical factors
- Inpatient stay factors
- Medication related
- Laboratory results
- Glycaemic status
Co-author Theodorus Arvanitis (Institute of Digital Healthcare at WMG, University of Warwick, Coventry, UK) comments: “The most common risk factor is in the demographic category of age, and the second most important factor is co-morbidity burden; this comes under the patient medical factors category, and means patients have more than one condition. We also identified BMI as a significant risk within the patient medical factors category, with those who were at the heavier end of the scales to be more at risk.
“Thirty-seven of the risk factors we identified from one research paper. This tell us that this research in general is still very early, and more studies are needed to identify the importance and possibly any other risk factors. This could decrease the mortality rate of diabetics discharged from hospitals in the future.”