Hyperglycemic crisis episodes up mortality risk in seniors
Lasting Mortality Risk Increase With Hyperglycemic Crises
HealthDay News — Geriatric patients diagnosed with diabetes have a higher mortality risk after hyperglycemic crisis episode during the first six years of follow-up, study findings suggest.
“The increase in the prevalence of diabetes in the geriatric population leads to a large disease burden, but previous studies of geriatric hyperglycemic crisis were focused on acute hyperglycemic crisis episode (HCE),” noted Chien-Cheng Huang, M.D., from the Chi Mei Medical Center in Taiwan, and colleagues in Diabetes Care.
To delineate the long-term mortality risk after HCE, the investigators used data from 13,551 geriatric patients with new-onset diabetes between 2000 and 2002. A total of 4,517 patients with HCE and 9,034 without HCE (controls) were followed through 2011.
Of the patients, 36.17% of patients with HCE and 18.73% of patients without HCE died during follow-up (P< 0.0001). The incidence rate ratios (IRRs) of death were significantly higher (2.82-fold) in patients with HCE (P<0.0001).
In the first month, mortality risk was highest (IRR, 26.56), and the increased risk persisted until four to six years after HCE (IRR, 1.49). The mortality ratio was 2.848 and 4.525 times higher in case subjects with one episode or two or more episodes of hyperglycemic crisis, respectively, after adjustment for age, sex, selected comorbidities, and monthly income.
Independent mortality predictors included older age, male sex, renal disease, stroke, cancer, chronic obstructive pulmonary disease, and congestive heart failure.
"Referral for proper education, better access to medical care, effective communication with a health care provider, and control of comorbidities should be done immediately after HCE," concluded the investigators.