Manejo de la hiperglicemia en el servicio de emergencia y su impacto en mortalidad y desenlaces desfavorables

Objectives: To determine the proportion of patients who achieved glycemic control within 24 hours of admission to the emergency department in three Peruvian hospitals, as well as to assess the relationship between the achievement of glycemic control at 24 hours and mortality and unfavorable outcomes. Methodology: An observational analytical cohort study was conducted in three Peruvian hospitals, including 730 patients admitted for hyperglycemia. Variables such as glycemic control, mortality, and unfavorable outcomes were examined using descriptive and multivariate statistical analyses. Results: The average age of the patients was 60 years, with a majority being male. 85.1% had a history of diabetes mellitus, and hypertension was the most prevalent comorbidity. 4% of patients died. Glycemic control was achieved in 45% of the patients. 34% received fixed doses of insulin. No association was found between glycemic control and mortality, the need for mechanical ventilation, or hemodialysis. Patients who achieved glycemic control had significantly shorter hospital stays compared to those who did not achieve control (51% vs. 60%; p=0.02). Conclusion: Glycemic control was achieved in 45% of patients admitted with hyperglycemia to the emergency department. The majority of patients received insulin in sliding scale regimens rather than fixed doses. Glycemic control within 24 hours was associated with a lower proportion of patients with prolonged hospital stays, although it was not associated with reduced mortality or the need for mechanical ventilation.