RESUMO
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Assuntos
Humanos , Masculino , Feminino , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca , Prognóstico , Ultrassonografia/instrumentação , Ultrassonografia/métodos , Ultrassonografia/tendências , Veia Cava Inferior/fisiologia , Veia Cava Inferior , Pulmão/patologia , Pulmão , Ventrículos do Coração/patologia , Ventrículos do CoraçãoRESUMO
BACKGROUND: To determine if antidiabetes treatment adjustment at discharge from an Emergency Department(ED) is associated with 30-day outcomes in patients with diabetes mellitus presenting to the ED with hypoglycemia. METHODS: Retrospective cohort observational study. Patients with diabetes mellitus presenting to the ED with hypoglycemia directly discharged from the ED between 2012-2014 were included. Primary outcome was a 30-day composite adverse event(mortality or revisiting). RESULTS: A total of 203 patients were included with a mean age of 69.7 (SD 18.9), mainly type 2 diabetics.Hypoglycemia was the primary diagnosis in 162(79%) of patients and antidiabetes treatment was adjusted at discharge in 98 (48%) of cases. Non-adjustment of antidiabetes treatment at ED discharge was an independent factor associated with a 30-day adverse event (OR=2.8; CI 95%=1.34-5.93; p=0.006). CONCLUSIONS: Non-adjustment of antidiabetes treatment at discharge in patients with diabetes mellitus presenting to the ED with hypoglycemia could be an independent factor of suffering a 30-day adverse event.
Assuntos
Diabetes Mellitus/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Alta do Paciente , Idoso , Serviço Hospitalar de Emergência , Feminino , Humanos , Hipoglicemia/diagnóstico , Hipoglicemia/etiologia , Masculino , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Fundamento: Determinar si ajustar el tratamiento antidiabético al alta se relaciona con los resultados a 30 días en los pacientes con diabetes mellitus atendidos por hipoglucemia en un servicio de urgencias (SU). Método: Estudio observacional de cohorte retrospectivo. Se incluyeron todos los pacientes con diabetes mellitus con hipoglucemia dados del alta desde SU entre 2012-2014. La variable resultado fue un evento adverso por cualquier causa a los 30 días. Resultados: El estudio se realizó en 203 pacientes con edad media de 69,7(DE 18,9) mayoritariamente con diabetes mellitus tipo 2. El diagnóstico de hipoglucemia fue principal en 162 (79%) y se realizó ajuste terapéutico en 98 (48%) casos. El no ajuste de tratamiento fue un factor independiente asociado con un evento adverso a los 30 días (OR=2,82; IC 95%=1,34-5,93; p=0,006). Conclusiones: No ajustar el tratamiento antidiabético al alta del SU podría ser un factor independiente de sufrir un resultado adverso a los 30 días en los pacientes con diabetes mellitus que presentaron hipoglucemia en un SU (AU)
Background: To determine if antidiabetes treatment adjustment at discharge from an Emergency Department (ED) is associated with 30-day outcomes in patients with diabetes mellitus presenting to the ED with hypoglycemia. Methods: Retrospective cohort observational study. Patients with diabetes mellitus presenting to the ED with hypoglycemia directly discharged from the ED between 2012-2014 were included. Primary outcome was a 30-day composite adverse event (mortality or revisiting). Results: A total of 203 patients were included with a mean age of 69.7 (SD18.9), mainly type 2 diabetics. Hypoglycemia was the primary diagnosis in 162 (79%) of patients and antidiabetes treatment was adjusted at discharge in 98 (48%) of cases. Non-adjustment of antidiabetes treatment at ED discharge was an independent factor associated with a 30-day adverse event (OR=2.8; CI 95%=1.34-5.93; p=0.006). Conclusions: Non-adjustment of antidiabetes treatment at discharge in patients with diabetes mellitus presenting to the ED with hypoglycemia could be an independent factor of suffering a 30-day adverse event (AU)
