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| 題 名 | Prognostic Factors of Hyperglycemic Hyperosmolar Nonketotic State=高血糖高滲透非酮酸症的預後因子 |
|---|---|
| 作 者 | 朱志勳; 李鎮堃; 林興中; 呂志成; | 書刊名 | 長庚醫學 |
| 卷 期 | 24:6 2001.06[民90.06] |
| 頁 次 | 頁345-351 |
| 分類號 | 415.668 |
| 關鍵詞 | 糖尿病; 糖尿病酮酸中毒; 高血糖滲透非酮酸症; Diabetes mellitus; Diabetic ketoacidosis; Hyperglycemic hyperosmolar nonketotic state; |
| 語 文 | 英文(English) |
| 英文摘要 | Background: To delineate the prognostic factors of patients suffering from hyperglycemic hyperosmolar nonketotic state (HHNK) in Taiwan. Methods: We reviewed the charts of patients who had been admitted to the Division of Endocrinology and Metabolism of Kaohsiung Veterans General Hospital from 1992 to 1998 due to HHNK. General and clinical data were collected. The influential factors for prognosis were determined. Results: One hundred and nineteen patients fulfilling the criteria of HHNK were included in our study. The mean age was 67.8!O11.7 years with male predominance. Twenty-nine patients died which produced a fatality rate of 24.4%. Eighty-six (72.3%) cases occurred in patients with known diabetic history, while another thirty-three (27.7%) occurred in patients with no diabetic history. Most patients received oral antidiabetic drugs before HHNK episodes. The patients who died had shorter length of inpatient stay than did survivors. The leading precipitating factor was infection (57.1%), followed by poor compliance of medication (21.0%) and undiagnosed diabetes (10.9%). Fifty patients (42%) had a history of stroke. The risk factors for death included precipitation of HHNK by infection and low Glasgow coma scale (GCS) on admission. Old age itself did not contribute to death. Severity of hyperglycemia or hyperosmolarity was also not an important prognostic factor. Multiple logistic regression revealed that low GCS on admission was the most influential factor of leading to death. Most of the patients who died did so due to underlying precipitating factors. Conclusions: Neither age nor osmolarity, but underlying precipitating factors and state of consciousness were the most influential factors affecting the prognosis of HHNK. (Chang Gung Med J 2001;24:345-51) |
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