X. Zhu, J. Jin, X. Hu, P. Zhang, Z. Huo, H. Yu, W. Liang, H. Guan, et al. (2026). Association of cerebrovascular disease with adverse outcomes in patients with diabetic ketoacidosis. Endocrine connections, 15(1). https://doi.org/10.1530/EC-25-0870

PubMed 41432125

[Abstract]
BACKGROUND: This study aimed to investigate the association between cerebrovascular disease (CBVD) and adverse in-hospital outcomes in patients with diabetic ketoacidosis (DKA).

METHODS: We conducted a retrospective analysis using the National Inpatient Sample data from 2016 to 2022, identifying 445,863 hospitalizations among adults with diabetes and CBVD. Within this cohort, 4,363 patients had DKA and 1,648 had hyperosmolar hyperglycemic state (HHS). Multivariable logistic regression was employed to control for demographic, socioeconomic, admission, comorbidity, and hospital factors.

RESULTS: Our findings revealed that among hospitalized adults with type 2 diabetes (T2DM) and CBVD, patients experiencing DKA had a significantly higher rate of in-hospital mortality compared to those with non-DKA/HHS cases. The likelihood of severe complications was notably increased in DKA patients. Furthermore, DKA hospitalizations were associated with an extended length of stay and an increased financial burden. When compared to HHS patients, those with DKA exhibited a greater risk of mortality, higher rate of complications, and higher resource utilization. In addition, within the cohort of patients with a primary diagnosis of T2DM DKA, those with CBVD had higher resource utilization and an increased incidence of complications.

CONCLUSIONS: Patients with DKA and CBVD experienced significantly poorer clinical outcomes and increased healthcare resource utilization compared to those with non-DKA/HHS and HHS. These findings highlight the adverse impact of CBVD on in-hospital outcomes for DKA patients, emphasizing the need for targeted prevention and timely multidisciplinary management strategies for this vulnerable population.