Treatment Outcome of Hyperglycemic Emergency and Predictors in Ethiopia

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Abstract Background Hyperglycemic Emergency (HE) denotes critical cases of decompensated diabetes mellitus (DM). Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are the extreme cases of HE. This study aims to assess the treatment outcome of HE and predictors. Method: Four-year medical records of DM patients admitted for HE at Hiwot Fana Specialized University Hospital (HFSUH) were reviewed retrospectively. The data abstraction tool was adapted from the preceding studies. Data were entered into and cleaned by Epi-InfoTM7 software. The statistical analysis was executed using the statistical package for social sciences software (SPSS) version 24. Chi-square test and student’s t-test were done to compare categorical and continuous variables. Logistic regression with the level of α set at 0.05 and AOR of 95% CI was done to determine the predictors. Statistical significance was established at AOR ≠ 1 within a 95% CI and P-value < 0.05. The model was verified using the Hosmer-Lemeshow goodness of fit test (P = 0.392). Results This study included 321 eligible patients. The median duration of hospital stay was 7 days. The pooled HE mortality was 16.5%; 21.4% of HHS and 11.1% of DKA died. Infection (AOR = 3.74, 95% CI: 1.85–7.57, P < 0.001), comorbidity (AOR = 2.95, 95% CI: 1.34–6.48, P = 0.007), and lower admission Glasgow Coma Scale score ≤ 8 (AOR = 2.58, 95% CI: 1.17–5.71, P = 0.019) were the independent predictors of HE mortality. Conclusion Mortality and duration of hospital stay stand high among DM patients admitted for HE at HFSUH. Infection, comorbidity, and lower admission GCS ≤ 8 are the independent predictors of HE mortality. Operative strategies targeting the predictors ought to be devised to control the morbidity and mortality among DM patients hospitalized for HE.

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