Hyperglycemic emergencies in a tertiary health facility
Clinical presentation and predictors of mortality
Keywords:
Hyperglycemic emergencies, Diabetes Ketoacidosis, Hyperglycemic Hyperosmolar State, mortalityAbstract
Abstract
Aim: To assess the clinical presentations and predictors of mortality of hyperglycemic emergencies (HE)
in persons with diabetes mellitus (DM) presenting in a tertiary health facility in Nigeria.
Methods: This was a two-year retrospective review of hospital records of persons with DM in a tertiary
hospital in Nigeria. We retrieved data on person’s demographics, clinical and laboratory characteristics
into Microsoft Excel and analyzed with STATA version 14.
Results: A total of 195 (42.4%) out of 460 persons admitted with DM fulfilled the eligibility criteria.
Diabetic ketoacidosis (DKA) was present in 42.6%, mixed hyperglycemic emergency (MHE) in 34.9%
and hyperglycemic hyperosmolar state (HHS) in 22.5%. Mortality in HE was 8.7%. The common clinical
presentation were: osmotic symptoms (71.3%), tachypnoea (46.7%), tachycardia (42.6%). Elevated anion
gap (89.2%) and anemia (80.5%) were the common laboratory findings. Infections (86.7%), noncompliance (79.5%) and newly diagnosed DM were the common precipitants of HE. Significant
predictors of mortality were: duration of DM between 5-9 years, Glasgow Coma Scale (GCS) < 8,
hypotension, and hypokalemia.
Conclusion: HE is still a common cause of hospitalization and mortality in persons with DM; and
features such osmotic symptoms, tachypnea and high anion gap metabolic acidosis should alert the
clinician.
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