prikaz prve stranice dokumenta The impact of hyperosmolarity on long-term outcome in patients presenting with severe hyperglycemic crisis: a population based study
  Download
PDF 941.45 KB
Scientific paper - Original scientific paper
The impact of hyperosmolarity on long-term outcome in patients presenting with severe hyperglycemic crisis: a population based study
Experimental and Clinical Endocrinology & Diabetes, 126 (2018), 9; 564-569. https://doi.org/10.1055/s-0043-117416
Kruljac, Ivan; Ćaćić, Miroslav; Ćaćić, Petra; Biloš, Lora; Kust, Davor; Perić, Božidar; Filipović-Grčić, Maja; Mirošević, Gorana; Ostojić, Vedran; Štefanović, Mario; Vrkljan, Milan

Institutional repository: Dr Med - University of Zagreb School of Medicine Digital Repository

Cite this document

Kruljac, I., Ćaćić, M., Ćaćić, P., Biloš, L., Kust, D., Perić, B. ... Vrkljan, M. (2018). The impact of hyperosmolarity on long-term outcome in patients presenting with severe hyperglycemic crisis: a population based study. Experimental and Clinical Endocrinology & Diabetes, 126. (9), 564-569. doi: 10.1055/s-0043-117416

Kruljac, Ivan, et al. "The impact of hyperosmolarity on long-term outcome in patients presenting with severe hyperglycemic crisis: a population based study." Experimental and Clinical Endocrinology & Diabetes, vol. 126, no. 9, 2018, pp. 564-569. https://doi.org/10.1055/s-0043-117416

Kruljac, Ivan, Miroslav Ćaćić, Petra Ćaćić, Lora Biloš, Davor Kust, Božidar Perić, Maja Filipović Grčić, et al. "The impact of hyperosmolarity on long-term outcome in patients presenting with severe hyperglycemic crisis: a population based study." Experimental and Clinical Endocrinology & Diabetes 126, no. 9 (2018): 564-569. https://doi.org/10.1055/s-0043-117416

Kruljac, I., et al. (2018) 'The impact of hyperosmolarity on long-term outcome in patients presenting with severe hyperglycemic crisis: a population based study', Experimental and Clinical Endocrinology & Diabetes, 126(9), pp. 564-569. doi: 10.1055/s-0043-117416

Kruljac I, Ćaćić M, Ćaćić P, Biloš L, Kust D, Perić B, and sur.. The impact of hyperosmolarity on long-term outcome in patients presenting with severe hyperglycemic crisis: a population based study. Experimental and Clinical Endocrinology & Diabetes [Internet]. 2018 September [cited 2024 December 24];126(9):564-569. doi: 10.1055/s-0043-117416

I. Kruljac, et al., "The impact of hyperosmolarity on long-term outcome in patients presenting with severe hyperglycemic crisis: a population based study", Experimental and Clinical Endocrinology & Diabetes, vol. 126, no. 9, pp. 564-569, September 2018. [Online]. Available at: https://urn.nsk.hr/urn:nbn:hr:105:919883. [Accessed: 24 December 2024]

Metadata
Title (english)The impact of hyperosmolarity on long-term outcome in patients presenting with severe hyperglycemic crisis: a population based study
AuthorIvan Kruljac
AuthorMiroslav Ćaćić
AuthorPetra Ćaćić
AuthorLora Biloš
AuthorDavor Kust
AuthorBožidar Perić
AuthorMaja Filipović-Grčić
AuthorGorana Mirošević
AuthorVedran Ostojić
AuthorMario Štefanović
AuthorMilan Vrkljan
Author's institutionUniversity of Zagreb
School of Medicine
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Abstract (english)
AIMS: We compared characteristics of patients with hyperglycemic hyperosmolar state (HHS) and patients with severe hyperglycemia without the signs of hyperosmolarity and ketoacidosis; analyzed long-term all-cause mortality and potential prognostic factors. ----- METHODS: The studied population included 261 749 adults. HHS was diagnosed in patients with plasma glucose >33.0 mmol/L, ketonuria <1+, and serum osmolarity >320 mmol/L. Patients with plasma glucose >33.0 mmol/L, ketonuria <1+ and serum osmolarity <320 mmol/L were considered as controls (nHHS). ----- RESULTS: During the 5-year period, we observed 68 episodes of HHS in 66 patients and 51 patients with nHHS. Patients with HHS were significantly older, had lower BMI, higher serum C-reactive protein and used diuretics and benzodiazepines more frequently. Mortality rates one, three and 12 months after admission were 19.0, 32.1 and 35.7% in the HHS group, and 4.8, 6.3 and 9.4% in the nHHS group (P<0.001). However, after adjustment for patient age, these differences were not statistically significant. In multivariate Cox regression in HHS group, mortality was positively associated with age, male gender, leukocyte count, amylase, presence of dyspnea and altered mental status, and the use of benzodiazepines, ACE inhibitors and sulphonylureas, while it was inversely associated with plasma glucose, bicarbonate, and the use of thiazides and statins. A nomogram derived from these variables had an accuracy of 89% in predicting lethal outcome. ----- CONCLUSIONS: Infection, use of furosemide and benzodiazepines may be important precipitating factors of HHS. Prospective clinical trials are mandatory to analyze the safety of ACE-inhibitors and benzodiazepines in elderly patients with diabetes.
Keywords (english)
Languageenglish
Publication typeScientific paper - Original scientific paper
Publication statusPublished
Peer reviewPeer review
Publication versionAccepted version
Journal titleExperimental and Clinical Endocrinology & Diabetes
Numberingvol. 126, no. 9, pp. 564-569
p-ISSN0947-7349
DOIhttps://doi.org/10.1055/s-0043-117416
URN:NBNurn:nbn:hr:105:919883
Publication2018-09
Document URLhttps://doi.org/10.1055/s-0043-117416
Type of resourceText
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2024-03-28 10:21:01