IF 1 4区 医学 Q3 PEDIATRICS Clinical Pediatrics Pub Date : 2025-03-12 DOI:10.1177/00099228251321899
Ahmed Badran, Amruta Thakkar, Despoina Galetaki, Assia Miller, Vatcharapan Umpaichitra, Renee Bargman, Vivian L Chin
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引用次数: 0

摘要

糖尿病酮症酸中毒(DKA)和高渗性高血糖状态(HHS)的混合表现在多达 27% 的高血糖急症中均有报道。这篇 15 年的回顾性病历回顾描述了本中心高血糖急症患儿的临床特征、风险因素和预后。在322名患者中,92%为非洲裔加勒比海人或黑人,平均年龄为13.6岁,其中266人(83%)患有DKA,52人(16%)患有DKA-HHS混合型,极少数患有HHS(1%,n = 4)。大多数(98%)DKA 和 DKA-HHS 组患者患有 1 型糖尿病(T1DM)。所有 4 名 HHS 患者均为 2 型糖尿病 (T2DM)。与 DKA 组相比,DKA-HHS 混合组的静脉输液率更高(P < .0001),发生急性肾损伤 (AKI) 的几率高出 4.3 倍,发生精神状态改变 (AMS) 的几率高出 3.3 倍。在 HHS 组中,50% 的患者出现 AMS 和 AKI,需要更高的静脉输液率(≥2 倍维持量)。临床医生应识别 DKA-HHS 混合病例,以尽量减少并发症。
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Hyperglycemic Emergencies in Minority Children and Adolescents With Diabetes.

Mixed presentation of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) has been reported in up to 27% of hyperglycemic emergencies. This 15-year retrospective chart review describes clinical features, risk factors, and outcomes among children presenting with hyperglycemic emergencies at our center. Out of 322 patients, 92% were Afro-Caribbean or Black with a mean age of 13.6 years, comprising 266 (83%) with DKA, 52 (16%) mixed DKA-HHS, and rarely with HHS (1%, n = 4). Most (98%) of DKA and DKA-HHS groups had type 1 diabetes mellitus (T1DM). All 4 patients with HHS had type 2 diabetes mellitus (T2DM). Compared with the DKA group, the mixed DKA-HHS group had higher IV fluid rates (P < .0001), 4.3-fold greater odds of acute kidney injury (AKI), and 3.3-fold greater odds of altered mental status (AMS). In the HHS group, 50% presented had AMS and AKI and required higher IV fluids rates (≥2× maintenance). Clinicians should recognize mixed cases of DKA-HHS to minimize complications.

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来源期刊
Clinical Pediatrics
Clinical Pediatrics 医学-小儿科
CiteScore
2.10
自引率
6.20%
发文量
189
审稿时长
3-8 weeks
期刊介绍: Clinical Pediatrics (CLP) a peer-reviewed monthly journal, is a must read for the busy pediatrician. CLP contains state-of-the-art, accurate, concise and down-to earth information on practical, everyday child care topics whether they are clinical, scientific, behavioral, educational, or ethical.
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