Treatment Outcome and Predictors of Mortality among Adult Diabetic Patients Admitted with Hyperglycemic Crises at Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia
Abstract
Background: Hyperglycemic crises are frequently experienced and yet perilous acute metabolic complications of diabetes mellitus. However, Treatment outcomes and predictors of mortality among adult diabetic patients admitted with hyperglycemic crises were not well studied in the study area. Therefore this study aimed to assess treatment outcomes and predictors of mortality among adult diabetic patients admitted with hyperglycemic crises at Hiwot Fana Comprehensive Specialized University Hospital.
Methods: A cross-sectional study was conducted on 213 adult diabetes patients admitted with hyperglycemic crises at the emergency department and medical wards of Hiwot Fana Comprehensive Specialized University Hospital from January 1, 2017, to December 31, 2019. Information on patient admission, treatment, and outcome attributes was extracted from medical records. The statistical analysis was performed using SPSS version 24. Logistic regression analysis was done to examine predictors of mortality.
Results: Diabetes ketoacidosis was the most common hyperglycemic crisis detected in 67.6% (95% CI: 61.05% - 73.54%) of the study participants. Recurrent hyperglycemia and hypoglycemia occurred in 124 (58.2%) and 51 (23.9%) of the patients, respectively. The mortality rate from hyperglycemic crises was 17.8% (95% CI: 12.9%-23.7%). Known diabetes (AOR = 3.6; 95% CI: 1.3 – 9.5), hypokalemia (AOR = 7.3; 95% CI: 1.2 – 23.7), serum creatinine >1.2 mg/dl (AOR = 3.1; 95% CI: 1.3 – 7.2), stroke (AOR = 5.3; 95% CI: 1.8 – 16.2), and sepsis (AOR = 4.4; 95% CI: 1.7–11.5) were independent predictors of mortality.
Conclusion: Mortality from hyperglycemic crises in the study setting was high. Metabolic treatment complications were common. A prior history of diabetes, hypokalemia, raised serum creatinine, stroke, and sepsis were independent predictors of mortality. Hence, clinicians ought to focus on these predictive factors and improve the treatment outcome of diabetes patients.
