The effect of blood gas analysis and Charlson comorbidity index evaluation on the prediction of hospitalization period in patients with diabetic hyperglycemic crisis

Abstract

Objective: This study aims to evaluate the effectiveness of blood gas analysis at the time of admission and additional Charlson comorbidity index (CCI) in predicting the hospitalization period of patients admitted to the emergency department (ED) with a hyperglycemic crisis. Materials and Method: This study was designed as retrospective, cross-sectional and observational. The patients who admitted to the ED with hyperglycemic crisis (diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome) and hospitalized were included in the study within 2 years between January 1, 2019, and January 1, 2021, in a level 3 education research hospital. The electronic patient database of the hospital was scanned for the determined period of the study with ICD codes [E10.1, E11.1, or E13.1 (diabetic ketoacidosis) or E11.0, E13.0, or E10.65 and E10.69 (hyperosmolar hyperglycemic syndrome)]. Patients under the age of 18 and patients whose disease histories could not be reached by blood tests were excluded from the study. Statistical significance was accepted as p<0.05. Results: A total of 93 patients included in this study, which of 48 (51.6%) were female and 45 (48.4%) were male. The mean age of the patients was 63.49±26.59. The mean hospitalization period was determined as 6.25±5.16 days. In total, 7 patients (7.5%) were followed up in the intensive care unit (ICU), while mortality was observed in 2 (2.15%) of these patients. It was determined that there was a statistically significant association between hospitalization period of the patients and their findings such as age (r=0.879, p<0.001), Charlson index (r=0.708, p<0.001), PH value (r=0.312, 0.002), HCO3 value (r=0.316, p=0.002), BE value (r=-0.315, p=0.002). Conclusion: It can be predicted that patients who admitted to the ED with DKA and HHS will have a long hospitalization due to blood gas analysis and comorbid diseases. Thus, the quality of treatment can be increased by measures such as education, early consultation of the diabetes team and early detection of triggering factors.

Keywords

• Blood gas analysis
• Diabetic ketoacidosis
• Hyperosmolar hyperglycemic syndrome
• Length of stay
• Emergency department

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