Hypoglycaemia without diabetes encountered by emergency medical services : a retrospective cohort study

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Pysyväisosoite

http://hdl.handle.net/10138/233481

Lähdeviite

Vihonen , H , Kuisma , M & Nurmi , J 2018 , ' Hypoglycaemia without diabetes encountered by emergency medical services : a retrospective cohort study ' , Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , vol. 26 , 12 . https://doi.org/10.1186/s13049-018-0480-7

Julkaisun nimi: Hypoglycaemia without diabetes encountered by emergency medical services : a retrospective cohort study
Tekijä: Vihonen, Hanna; Kuisma, Markku; Nurmi, Jouni
Tekijän organisaatio: HYKS erva
Clinicum
Department of Diagnostics and Therapeutics
HUS Emergency Medicine and Services
University of Helsinki
Päiväys: 2018-02-01
Kieli: eng
Sivumäärä: 9
Kuuluu julkaisusarjaan: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
ISSN: 1757-7241
DOI-tunniste: https://doi.org/10.1186/s13049-018-0480-7
URI: http://hdl.handle.net/10138/233481
Tiivistelmä: Background: The current study investigates the incidence, aetiology, and outcome of hypoglycaemia of patients without diabetes in the EMS. Methods: The study was a retrospective cohort study that utilized electronic EMS patient record system (population of one million). All patients encountered by EMS with plasma glucose Results: From EMS cases with a plasma glucose measurement a total of 5467 hypoglycaemic patients without diabetes were encountered by EMS during the study period with an incidence of 1082 (CI95% 1019-1148) per 100,000 inhabitants per year, corresponding 41.6%, (CI95% 40.8-42.3) of all hypoglycaemic patients. Of those patients, 3856 [71.6%, (CI95% 70.4-72.8)] were transported to hospital and 910 [23.2%, (CI95% 22.0-24.6)] had serious hypoglycaemia. The three main diagnosis groups that appeared in the subsequent hospital treatment associated with hypoglycaemia in all transported cases without diabetes as well with serious hypoglycaemia cases were: alcohol abuse [41.2%, (CI95% 39.7-42.8) and 42.2%, (CI95% 39.0-45.4)], hypothermia [17.2%, (CI95% 16.0-18.4) and 27.4%, (CI95% 24.6-30.4)], and malnutrition [16.9%, (CI95% 15.8-18.1) and 25.1%, (CI95% 22.4-28.0)]. Mortality ranged from 0.6-65.4% depending of admission reason and increased significantly at long-term. Non-Diabetics survival was less than with diabetics, when serious hypoglycaemia was present. Discussion: The most common possible hypoglycaemia related aetiological causes encountered in the EMS, alcohol abuse, hypothermia, and malnutrition, although frequent are often relatively benign conditions. These possible causes of hypoglycaemia can often be treated at scene or need only short hospital admissions. Hence they are not so prevalent in hospital studies. Conclusions: Hypoglycaemia without diabetes is commonly observed among the hypoglycaemic EMS cases. Main causes for it are alcohol abuse, hypothermia, and malnutrition. Mortality correlated with age, higher priority dispatch codes, and plasma glucose rate in multivariate logistic regression analysis. Some of the etiological subgroups carry a markedly high mortality rate.
Avainsanat: Glucose
Hypoglycaemia
Emergency medical service
Without diabetes
ASSOCIATION
MORTALITY
3121 General medicine, internal medicine and other clinical medicine
Vertaisarvioitu: Kyllä
Tekijänoikeustiedot: cc_by
Pääsyrajoitteet: openAccess
Rinnakkaistallennettu versio: publishedVersion


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