RESUMO
AIMS: To develop a prediction algorithm to rule out diabetic ketoacidosis (DKA) and non-ketotic hyperosmolar syndrome (NKHS) based on vital signs for early triage of patients with diabetes. METHODS: The subjects were consecutive adult diabetic patients with hyperglycemia (blood glucose >or=250mg/dl) who presented at an emergency department. Based on a derivation sample (n=392, 70% of 544 patients at a hospital in Okinawa), recursive partitioning analysis was used to develop a tree-based algorithm. Validation was conducted using the other 30% of the patients in Okinawa (n=152, internal validation) and patients at a hospital in Tokyo (n=95, external validation). RESULTS: Three risk groups for DKA/NKHS were identified: a high-risk group of patients with glucose >400mg/dl or systolic blood pressure <100mmHg; a low risk group of patients with glucose Assuntos
Cetoacidose Diabética/diagnóstico
, Hiperglicemia/complicações
, Coma Hiperglicêmico Hiperosmolar não Cetótico/diagnóstico
, Adulto
, Fatores Etários
, Idoso
, Idoso de 80 Anos ou mais
, Algoritmos
, Glicemia/metabolismo
, Cetoacidose Diabética/sangue
, Cetoacidose Diabética/etiologia
, Diagnóstico Diferencial
, Feminino
, Humanos
, Hiperglicemia/sangue
, Coma Hiperglicêmico Hiperosmolar não Cetótico/sangue
, Coma Hiperglicêmico Hiperosmolar não Cetótico/etiologia
, Masculino
, Pessoa de Meia-Idade
, Prognóstico
, Estudos Retrospectivos
, Medição de Risco
, Fatores de Risco
, Fatores de Tempo
, Triagem
, Sinais Vitais