Diabetic and Nondiabetic Endocrine Emergencies: Clinical Spectrum and Outcomes From a Tertiary Care Center in North...

Endocrine emergencies, although uncommon, are potentially life-threatening and require prompt diagnosis and timely intervention. Although diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are well described, data on nondiabetic endocrine emergencies remain limited, particularly from low-resource settings. This study aimed to evaluate spectrum, clinical characteristics, and outcomes of endocrine emergencies presenting to a tertiary care hospital in North India.

A prospective observational study was conducted over 18 months at a tertiary care academic hospital in North India. Patients aged ≥12 years presenting to the emergency department with endocrine emergencies were included. Clinical details, biochemical parameters, and outcomes were systematically recorded and analyzed.

A total of 212 patients were enrolled, with an incidence of 1.82 per 1000 emergency visits annually. DKA was the most frequent diagnosis (69.3%), followed by hypercalcemia (11.3%) and hypoglycemia (7.1%). HHS accounted for 3.8% of cases and had the highest mortality (50%). All patients with thyroid storm (n = 3) succumbed. Myxedema coma had a mortality rate of 33.3%. In DKA, older age, reduced estimated glomerular filtration rate, and higher plasma osmolality were associated with poor outcomes. In HHS, nonsurvivors had significantly higher osmolality (P = .029).

DKA is common and treatable, whereas HHS and thyroid storm carry high mortality, warranting early recognition and aggressive management.