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

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dc.contributor.author Vihonen, Hanna
dc.contributor.author Kuisma, Markku
dc.contributor.author Nurmi, Jouni
dc.date.accessioned 2018-03-15T14:27:01Z
dc.date.available 2018-03-15T14:27:01Z
dc.date.issued 2018-02-01
dc.identifier.citation 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
dc.identifier.other PURE: 100390191
dc.identifier.other PURE UUID: 49fe9fef-5911-416e-9906-8c1d586aa03c
dc.identifier.other WOS: 000423836800002
dc.identifier.other Scopus: 85041609531
dc.identifier.other ORCID: /0000-0002-3057-6524/work/42819759
dc.identifier.uri http://hdl.handle.net/10138/233481
dc.description.abstract 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. en
dc.format.extent 9
dc.language.iso eng
dc.relation.ispartof Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
dc.rights cc_by
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject Glucose
dc.subject Hypoglycaemia
dc.subject Emergency medical service
dc.subject Without diabetes
dc.subject ASSOCIATION
dc.subject MORTALITY
dc.subject 3121 General medicine, internal medicine and other clinical medicine
dc.title Hypoglycaemia without diabetes encountered by emergency medical services : a retrospective cohort study en
dc.type Article
dc.contributor.organization HYKS erva
dc.contributor.organization Clinicum
dc.contributor.organization Department of Diagnostics and Therapeutics
dc.contributor.organization HUS Emergency Medicine and Services
dc.contributor.organization University of Helsinki
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1186/s13049-018-0480-7
dc.relation.issn 1757-7241
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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