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Publication Type
Journal Article
UWI Author(s)
Author, Analytic
Chung, S. T. ; Perue, G. G. ; Johnson, A. ; Younger, Novie O. ; Hoo, C. S. ; Pascoe, R. W. ; Boyne, M. S.
Author Affiliation, Ana.
n/a
Article Title
Predictors of hyperglycaemic crises and their associated mortality in Jamaica
Medium Designator
n/a
Connective Phrase
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Journal Title
Diabetes Res Clin Pract
Translated Title
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Reprint Status
n/a
Date of Publication
2006
Volume ID
73
Issue ID
2
Page(s)
184-90
Language
eng
Connective Phrase
n/a
Location/URL
n/a
ISSN
0168-8227 (Print)
Notes
n/a
Abstract
The objective of the study was to determine the clinical characteristics and mortality of patients with hyperglycaemic hyperosmolar syndrome (HHS) and diabetic ketoacidosis (DKA) at a Jamaican tertiary care hospital. In a retrospective study of 1560 admissions for diabetes during the period 1998-2002, 980 dockets were reviewed and 164 individuals met the ADA diagnostic criteria for DKA or HHS. Patients with HHS were older than DKA patients (64.5 years [95% CI: 60.7-68.4] versus 35.9 years [95% CI: 30.2-41.6]), but were not more likely to be non-compliant with medications, infected, or male. Overall, 24% had a mixed DKA/HHS syndrome. Most DKA patients had type 2 diabetes (62%). Only 2% of HHS and 6% of DKA/HHS patients had type 1 diabetes. Syndrome specific mortality was: DKA 6.7%, HHS 20.3%, and DKA/HHS 25% (p for trend=0.013). Mortality increased significantly with age, especially in patients > or =50 years. Significant univariate predictors of mortality were altered mental status on admission, co-existing medical disease, increasing age, older age at onset of diabetes, acute stressors, and DKA/HHS. In multivariate models, only altered mental status was significant (OR=3.59; 95% CI: 1.24-10.41). Hence, hyperglycaemic crises in a Jamaican tertiary care hospital are associated with significant mortality especially in patients who are older or with altered mental status.....
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