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Predictors of hyperglycaemic crises and their associated mortality in Jamaica

Stephanie T Chung1, Gillian Gordon Perue, Ayesha Johnson

  • 1Tropical Medicine Research Institute, University of West Indies, Mona, Jamaica.

Diabetes Research and Clinical Practice
|February 7, 2006
PubMed

Insights

Hyperglycaemic hyperosmolar syndrome (HHS) and diabetic ketoacidosis (DKA) carry significant mortality in Jamaica. Older patients and those with altered mental status face the highest risk, highlighting the need for targeted interventions.

Area of Science:

  • Endocrinology
  • Diabetology
  • Public Health

Background:

  • Diabetic ketoacidosis (DKA) and hyperglycaemic hyperosmolar syndrome (HHS) are severe diabetes complications.
  • Understanding their clinical characteristics and mortality is crucial for effective management.

Purpose of the Study:

  • To determine the clinical features and mortality rates of DKA and HHS patients.
  • To identify risk factors associated with mortality in these hyperglycaemic crises.

Main Methods:

  • Retrospective review of 980 patient dockets from 1560 diabetes admissions (1998-2002).
  • Analysis of 164 patients meeting American Diabetes Association (ADA) criteria for DKA or HHS.
  • Comparison of patient demographics, clinical characteristics, and mortality between DKA and HHS groups.

Main Results:

  • HHS patients were older (64.5 years) than DKA patients (35.9 years).
  • Syndrome-specific mortality: DKA 6.7%, HHS 20.3%, mixed DKA/HHS 25%.
  • Mortality significantly increased with age (≥50 years) and altered mental status on admission (OR=3.59).

Conclusions:

  • Hyperglycaemic crises in Jamaica are associated with substantial mortality.
  • Advanced age and altered mental status are key predictors of mortality.
  • Urgent interventions are needed for high-risk patients with DKA and HHS.

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