The impact of hyperosmolarity on long-term outcome in patients presenting with severe hyperglycemic crisis: a population based study
| Autor: | Milan Vrkljan, Mario Štefanović, Davor Kust, Vedran Ostojić, Petra Ćaćić, Božidar Perić, Miroslav Ćaćić, Lora Stanka Kirigin Biloš, Gorana Mirošević, Ivan Kruljac, Maja Filipović-Grčić |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Cross-sectional study Endocrinology Diabetes and Metabolism Population Angiotensin-Converting Enzyme Inhibitors 030209 endocrinology & metabolism 030204 cardiovascular system & hematology Diabetic Ketoacidosis Cohort Studies Benzodiazepines 03 medical and health sciences 0302 clinical medicine Endocrinology Risk Factors Internal medicine Diabetes mellitus Internal Medicine medicine Humans education Aged Aged 80 and over education.field_of_study business.industry Mortality rate Furosemide Ketosis General Medicine Middle Aged medicine.disease Ketoacidosis Cross-Sectional Studies Diabetes Mellitus Type 2 Hyperglycemic Hyperosmolar Nonketotic Coma Ketonuria Female hyperglycemia business Cohort study medicine.drug |
| Popis: | Aims We compared characteristics of patients with hyperglycemic hyperosmolar state (HHS) and patients with severe hyperglycemia without the signs of hyperosmolarity and ketoacidosis; analyzed long-term all-cause mortality and potential prognostic factors. Methods The studied population included 261 749 adults. HHS was diagnosed in patients with plasma glucose >33.0 mmol/L, ketonuria 320 mmol/L. Patients with plasma glucose >33.0 mmol/L, ketonuria Results During the 5-year period, we observed 68 episodes of HHS in 66 patients and 51 patients with nHHS. Patients with HHS were significantly older, had lower BMI, higher serum C-reactive protein and used diuretics and benzodiazepines more frequently. Mortality rates one, three and 12 months after admission were 19.0, 32.1 and 35.7% in the HHS group, and 4.8, 6.3 and 9.4% in the nHHS group (P Conclusions Infection, use of furosemide and benzodiazepines may be important precipitating factors of HHS. Prospective clinical trials are mandatory to analyze the safety of ACE-inhibitors and benzodiazepines in elderly patients with diabetes. |
| Databáze: | OpenAIRE |
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