Predictors of hyperglycaemic crises and their associated mortality in Jamaica

Stephanie T. Chung, Gillian Gordon Perue, Ayesha Johnson, Novie Younger, Carla S. Hoo, Rosemarie Wright Pascoe, Michael S. Boyne

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

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 ≥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.

Original languageEnglish (US)
Pages (from-to)184-190
Number of pages7
JournalDiabetes research and clinical practice
Volume73
Issue number2
DOIs
StatePublished - Aug 2006
Externally publishedYes

Keywords

  • Diabetes
  • Hyperosmolar
  • Jamaica
  • Ketoacidosis
  • Mortality

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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