Hypoglycemia Detected by Blood Gas and Biochemistry Tests in Adult Emergency Department Patients: Insights from a High-Volume Tertiary Hospital
Abstract
Background: Hypoglycemia is a common endocrine emergency that can lead to severe morbidity and mortality. Despite its clinical significance, data on short-term mortality and its determinants in emergency department (ED) settings remain limited. Understanding risk factors influencing early outcomes is essential for timely intervention and improved survival.
Methods: This retrospective observational study was conducted at the adult ED of a high-volume tertiary hospital between January 2020 and December 2024. Adult patients (≥18 years) with plasma glucose <50 mg/dL confirmed simultaneously by both arterial blood gas and biochemistry tests were included. Demographic features, comorbidities, diagnoses, treatment modalities, and outcomes were analysed. Logistic regression was applied to identify independent predictors of 30-day all-cause mortality.
Results: A total of 760 patients met inclusion criteria. The median age was 72 years, and 50.9% were male. Hypertension (60.5%), coronary artery disease (42.9%), and chronic kidney disease (23.7%) were the most prevalent comorbidities. DM was present in 50.8% of cases, while malignancy accounted for 20.3%. Overall, 30-day mortality was 18.9%, but significantly higher among patients with malignancy (38.2% vs. 14.8%, p<0.001) and non-diabetic hypoglycemia. Patients with isolated hypoglycemia had markedly lower mortality (6.7%) compared to those with systemic illnesses (92.1%, p<0.001). Multivariate analysis identified age (OR 1.020; p=0.030), malignancy (OR 2.434; p=0.005), glucose treatment modality (OR 2.291; p<0.001), diagnostic category (OR 2.509; p=0.037), and diabetes status (OR 2.796; p<0.001) as independent predictors of mortality.
Conclusion: Hypoglycemia in the ED is associated with considerable short-term mortality, particularly among elderly, malignant, and non-diabetic patients. While isolated hypoglycemia indicates more favorable outcomes, refractory cases requiring repeated glucose therapy predict poor prognosis. These findings highlight the need for rapid identification of underlying causes and early recognition of high-risk patients to improve survival outcomes.
Keywords
Supporting Institution
The authors received no specific funding for this work.
Ethical Statement
Ethical approval for this study was obtained from the local ethics committee of the tertiary referral hospital (Decision No: TABED 2-25-834, Date: 19.02.2025).
Thanks
None.
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