Concurrent Risk Factors to Mortality in Hypoglycemia

Background & Objectives: In this study we aim to identify the demographic and clinical characteristics of hypoglycemic patients in emergency department that associated with mortality. This is a retrospective cross-sectional descriptive study. Methods: Adult patients with hypoglycemia received in an emergency department over a 27 month period were included. Hypoglycemia is defined as an initial fast glucose or serum glucose of less than 60 mg/dL. The associations of demographic and clinical characteristics with the patient mortality were evaluated using Student's t-test for continuous parameter and χ (2) test for discontinuous parameters. There were 186 hypoglycemic patients included in this study. Results: Of the patients included in this study, the mean age was 70.5±15.3years and 90 (48%) were females. The mean glucose level was 34.9±12.4 mg/dL. There were 21 (11.3%) non-survivors. Characteristics significantly associated with mortality were elevated heart rate (HR 85.3 ±15.9 / min vs 95.7± 29.5 /min p<0.05), lower blood pressure (SBP 141.7 ±27.3 mmHg vs 120.0 ±41.2 mmHg p<0.05, DBP 74.6±16.9 mmHg vs 63.7±23.8 mmHg p<0.05) , elevated liver function test (GOT 82±312 IU/L vs 324±460.8 IU/L p<0.05), elevated potassium (4 ±1 vs 4.7±1.2 p<0.05), liver cirrhosis (7.3% vs 33.3% p<0.01) , acute renal failure (23.6% vs 47.6% p<0.05) , biliary tract infection (BTI 1.8% vs 9.5% p<0.05) and/or cancer (7.3% vs 42.9% p<0.05). Conclusion: Several clinical characteristics were identified that associated with the mortality of hypoglycemic patients in emergency department. Mortality rates of hypoglycemic patients who present to the emergency department are significantly higher in those with signs of cardiovascular compromise, hepatic problem (liver cirrhosis, biliary tract infection), acute renal failure and concomitant malignancy. Elderly is not an aggravating factor in hypoglycemic mortality.