Nkoke Clovis, Bain Luchuo Engelbert, Makoge Christelle, Teuwafeu Denis, Mapina Alice, Nkouonlack Cyrille, Kouam Wilfred, Jingi Ahmadou Musa, Choukem Simeon Pierre
Buea Regional Hospital and Clinical Research Education, Networking and Consultancy, Buea, Cameroon.
Clinical Research Education, Networking and Consultancy (CRENC), Douala, Cameroon.
Pan Afr Med J. 2021 Aug 27;39:274. doi: 10.11604/pamj.2021.39.274.14371. eCollection 2021.
hyperglycemic emergencies (diabetic ketoacidosis and hyperglycemic hyperosmolar state) are the most common serious acute metabolic complications of diabetes which result in significant morbidity and mortality. There is paucity of data on hyperglycemic emergencies in Cameroon. The objective of this study was to investigate the precipitants and outcomes of patients admitted for hyperglycemic emergencies in the Buea Regional Hospital in the South West Region of Cameroon.
in this retrospective study the medical records of patients admitted for hyperglycemic emergencies between 2013 and 2016 in the medical unit of the Buea Regional Hospital were reviewed. We extracted data on demographic characteristics, admission clinical characteristics, precipitants, and treatment outcomes. Logistic regression was used to determine predictors of mortality.
data were available for 60 patients (51.7% females) admitted for hyperglycemic emergencies. The mean age was 55.2±16.3 (range 18-86). Overall there were 51 (85%) cases of hyperosmolar hyperglycemic state. Twenty six (43.3%) of the patients had hypertension. The most common precipitants of hyperglycemic emergencies were infections (41.7%), newly diagnosed diabetes (33.3%) and non-adherence to medications (33.3%). Mean admission blood glucose was 574mg/dl±70.0mg/dl. The median length of hospital stay was 6 days. Overall case fatality rate was 21.7%. Six (46.2%) deaths were related to infections. Predictors of mortality were a Glasgow coma score <13(p<0.001), a diastolic blood pressure <60 mmHg (p=0.034) and a heart rate >90(0.057) on admission.
admission for hyperglycemic emergencies in this semi-urban hospital is associated with abnormally high case fatality. Infections, newly diagnosed diabetes and non-adherence to medications are the commonest precipitants of hyperglycemic emergencies. Public health measures to reduce morbidity and mortality from hyperglycemic crisis are urgently needed.
高血糖急症（糖尿病酮症酸中毒和高血糖高渗状态）是糖尿病最常见的严重急性代谢并发症，会导致显著的发病率和死亡率。喀麦隆关于高血糖急症的数据匮乏。本研究的目的是调查喀麦隆西南地区布埃亚地区医院收治的高血糖急症患者的诱发因素和预后情况。
在这项回顾性研究中，对布埃亚地区医院内科2013年至2016年期间收治的高血糖急症患者的病历进行了回顾。我们提取了有关人口统计学特征、入院临床特征、诱发因素和治疗结果的数据。采用逻辑回归分析来确定死亡率的预测因素。
有60例因高血糖急症入院的患者的数据可供分析（女性占51.7%）。平均年龄为55.2±16.3岁（范围18 - 86岁）。总体而言，有51例（85%）为高血糖高渗状态病例。26例（43.3%）患者患有高血压。高血糖急症最常见的诱发因素是感染（41.7%）、新诊断的糖尿病（33.3%）和不遵医嘱服药（33.3%）。入院时平均血糖为574mg/dl±70.0mg/dl。住院时间中位数为6天。总体病死率为21.7%。6例（46.2%）死亡与感染有关。死亡率的预测因素为入院时格拉斯哥昏迷评分<13（p<0.001）、舒张压<60 mmHg（p = 0.034）和心率>90（0.057）。
在这家半城市医院，高血糖急症入院患者的病死率异常高。感染、新诊断的糖尿病和不遵医嘱服药是高血糖急症最常见的诱发因素。迫切需要采取公共卫生措施以降低高血糖危象的发病率和死亡率。
