Abstract
Background: Hyperglycaemic emergency (HE) is a frequent complication of diabetes mellitus (DM) and one of the commonest causes of hospitalization and death among people living with diabetes and previously unknown diabetes. Mortality from HE is still high in developing countries such as Nigeria; mortality being dependent on co-morbid conditions and precipitating factors. There is a paucity of published reports in the literature of any association between pre-hospitalization care settings and outcome of HE treatment, hence, the need for this study.
Materials and Methods: This was a prospective observational study carried out to assess the association between pre-hospitalization care settings (see definition of terms) and outcome of HE managed at Federal Medical Centre (FMC) Umuahia, Nigeria. One hundred and ten consecutive adult patients managed for HE at FMC, Umuahia were studied. Data from the subjects included bio-data, history of being a known diabetic or not, where diabetes care was accessed and anti-diabetic medications prior to HE. Primary outcome measures were survival and death. Analysis of data was done using SPSS 20.0 and the level of statistical significance was set at p < 0.05.
Results: Mean age of subjects was 58.10 ± 15.03 years. Male: female ratio was 1: 1.4.While HE constituted 15.6% of all medical admissions, mortality from HE was 10%. Most of the new onset diabetes and all the fourteen subjects who were accessing diabetes care from the diabetes clinic of FMC, Umuahia or similar tertiary health facilities survived. Forty five (90%) of the 50 subjects who were accessing care at the peripheral hospitals survived. A significant association was found between pre-hospitalization care settings and outcome of HE.
Conclusion: This study has shown that the pre-hospitalization care setting of patients managed for HE has a significant contribution to the outcome of treatment. It, also, showed that new-onset diabetes is not associated with poor outcome.
Keywords: pre-hospitalization care settings, HE, new-onset diabetes, outcome of hospitalization.
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Corresponding Author
Nkpozi MO
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DOI: https://dx.doi.org/10.18535/jmscr/v7i2.104
