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急诊科低血糖的诱发因素。

Predisposing factors for hypoglycaemia in the emergency department.

作者信息

Su Yu-Jang, Liao Chia-Jung

机构信息

1 Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan.

2 Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.

出版信息

J Int Med Res. 2019 Jun;47(6):2404-2412. doi: 10.1177/0300060519842037. Epub 2019 Apr 16.

Abstract

OBJECTIVE

Hypoglycaemia is a common complication of diabetes mellitus. Previous studies suggest that hypoglycaemic episodes may occur with other comorbidities, influencing the outcome of recovery. Recognising the predisposing factors for hypoglycaemic episodes in the emergency department is important. Therefore, we investigated the characteristics of and predisposing factors for hypoglycaemia in the emergency department.

METHODS

Data from 186 patients were retrospectively collected from a medical centre in northern Taiwan. We divided the patients into the advanced-age group (132 patients) and the younger group (54 patients). Associated data collected for statistical analysis included vital signs on arrival, first measured blood glucose level, laboratory results, related comorbidities, length of hospital stay, and survival to discharge.

RESULTS

Hypoglycaemia was more frequently observed in women in the advanced-age group than in the younger group. Tachycardia and elevated systolic blood pressure were less predominant in the advanced-age group than younger group. More patients in the advanced-age group had concurrent infection, and more patients in the younger group had liver dysfunction, elevated liver enzymes, liver cirrhosis, and concurrent stroke.

CONCLUSIONS

Closer attention should be paid to the possibility of infection in patients of advanced age. Liver disease and stroke need to be ruled out in younger patients.

摘要

目的

低血糖是糖尿病的常见并发症。先前的研究表明,低血糖发作可能与其他合并症同时发生,影响恢复结果。在急诊科识别低血糖发作的易感因素很重要。因此,我们调查了急诊科低血糖的特征和易感因素。

方法

回顾性收集了台湾北部一家医疗中心186例患者的数据。我们将患者分为高龄组(132例患者)和年轻组(54例患者)。收集用于统计分析的相关数据包括入院时的生命体征、首次测量的血糖水平、实验室检查结果、相关合并症、住院时间和出院存活率。

结果

高龄组女性低血糖的发生率高于年轻组。高龄组心动过速和收缩压升高的情况比年轻组少见。高龄组更多患者并发感染,年轻组更多患者有肝功能障碍、肝酶升高、肝硬化和并发中风。

结论

应更加关注高龄患者感染的可能性。年轻患者需要排除肝脏疾病和中风。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f415/6567738/3509e41e7221/10.1177_0300060519842037-fig1.jpg

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