Hyperglycemic crises in older adults: a descriptive study in a university hospital in Latin America
DOI:
https://doi.org/10.47196/diab.v58i2.739Keywords:
diabetes mellitus, hyperglycemia, medical emergenciesAbstract
Introduction: acute complications of diabetes mellitus (DM) are ketoacidosis (DKA), hyperosmolar hyperglycemic syndrome (HHS) and mixed disorders (MD).
Objectives: to estimate prevalence and describe the characteristics and evolution of patients who presented any of these hyperglycemic crises.
Materials and methods: cross-sectional cohort of adults admitted to the emergency room from January 2017 to December 2019.
Results: during the period of study, 119 patients met the definition of hyperglycemic crisis, yielding a prevalence of 0.07%; being 60.5% HHS, 31.93% DKA, and 7.57% MD. The median age was 81 years, and 64% had a history of DM. In HHS, the main triggering factor was infections; in DKA, acute myocardial infarction and/or refusal to eat. 80.6% of patients required hospitalization, with associated factors being female sex (OR 3.20; 95%CI 1.20-8.49; p=0.01), age (OR 1.03; 95%CI 1.01-1.05; p=0.01), and the diagnosis of DKA (OR 6.30; 95%CI 1.39-28.46; p=0.01). A history of DM was a protective factor (OR 0.21; 95%CI 0.05-0.75; p=0.01). In-hospital mortality was 34.38% (95%CI 24.97-44.76).
Conclusions: prevalence of hyperglycemic crises was low, but high mortality was recorded, for which an early diagnosis and timely and protocolized treatment of the crisis and its triggering cause are essential.
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