The association between diabetes mellitus and postoperative cognitive dysfunction: a systematic review and meta-analysis

作者：Hongbo Liu, Jiali Chen, Jitao Ling, Yuting Wu, Pingping Yang, Xiao Liu, Jianping Liu, Deju Zhang, Xiaoping Yin, Peng Yu, Jing Zhang · 发表于：International Journal of Surgery · 年份：2024 · DOI：10.1097/js9.0000000000002156 · 被引用次数：15 · 研究领域：Intensive Care Unit Cognitive Disorders、Hyperglycemia and glycemic control in critically ill and hospitalized patients、Enhanced Recovery After Surgery

BACKGROUND: Postoperative cognitive dysfunction (POCD) is a typical consequence following surgery, particularly in cardiac surgeries. Despite its high incidence, the underlying etiology remains unclear. While diabetes mellitus (DM) has been associated with cognitive impairment, its specific function in POCD development remains unidentified. This study aims to evaluate the connection between DM and the risk of POCD. METHODS: We conducted a comprehensive search of PubMed, Embase, Web of Science, and the Cochrane Library databases for studies of DM and risk with POCD, collecting data up to 14 September 2023. We assessed publication bias, heterogeneity, and study quality, adhering to PRISMA and AMSTAR guidelines. RESULTS: Our study comprised 38 trials involving 8748 individuals, with 7734 patients undergoing follow-up. The pooled results showed that individuals with DM had an increased incidence of POCD compared to nondiabetic individuals (RR: 1.44, 95% CI: 1.26-1.65). The incidence of POCD was significantly higher in the group of patients with an average age older than 65 years (RR: 1.69, 95% CI: 1.30-2.20) compared with diabetic patients with an average age younger than 65 years (RR: 1.29, 95% CI: 1.09-1.64). Compared with diabetic patients undergoing cardiac surgery (RR: 1.33, 95% CI: 1.15-1.53), patients receiving non-cardiac surgery showed a greater incidence of POCD (RR: 2.01, 95% CI: 1.43-2.84). CONCLUSION: Current evidence underscores that diabetic patients face a signifi...