Diabetic ketoacidosis and hyperosmolar hyperglycemic state in diabetes patients with heart failure: insight from the National inpatient sample.

IF 2 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

BMC Cardiovascular Disorders Pub Date : 2025-05-20 DOI:10.1186/s12872-025-04832-3

Hasan Alroobi, Soha Dargham, Ziyad Mahfoud, Amin Jayyousi, Jassim Al Suwaidi, Charbel Abi Khalil

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引用次数: 0

Abstract

Background: Diabetic Ketoacidosis (DKA) and Hyperosmolar Hyperglycemic State (HHS) are acute, life-threatening hyperglycemic conditions in diabetes. We aim to assess in-hospital cardiovascular outcomes of DKA and HHS in type 2 diabetes (T2D) patients with heart failure (HF) and compare both complications.

Methods: The National Inpatient Sample database was used to gather data on T2D patients admitted for HF (primary diagnosis) from 2008 to 2019. The secondary diagnoses were DKA or HHS. The outcomes investigated were mortality, ischemic stroke, acute renal failure, and cardiogenic shock.

Results: Diabetes HF patients with DKA were younger than those without HHS-DKA, more likely to be females, and had a higher prevalence of coronary artery disease and chronic kidney disease. DKA was associated with higher adjusted risk of mortality (aOR = 2.75[2.42-3.13)], ischemic stroke (aOR = 2.51[1.80-3.49]), acute renal failure (aOR = 1.54[1.45-1.64]), and cardiogenic shock (aOR = 2.53[2.19-2.92]. Diabetes HF patients with HHS were also younger but had more comorbidities than those without HHS-DKA. However, HHS was only associated with an increased adjusted risk of acute renal failure (aOR = 1.59[1.49-1.70]. When both hyperglycemic groups were compared, DKA patients were younger and had fewer comorbidities. However, they had a higher adjusted risk of mortality (aOR = 2.90[2.22-3.79] and cardiogenic shock (aOR = 2.86 [2.13-3.83], but not acute renal failure or stroke.

Conclusions: DKA and HHS are associated with worse cardiovascular outcomes in heart failure patients with type 2 diabetes. Further, when both conditions were compared, the mortality risk and cardiogenic shock were higher in DKA compared to HHS. Implementing tailored fluid and electrolyte management, optimizing insulin protocols, and enhancing monitoring with early intervention could be lifesaving for these high-risk patients.

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糖尿病合并心力衰竭患者的糖尿病酮症酸中毒和高渗性高血糖状态：来自全国住院患者样本的见解。

背景：糖尿病酮症酸中毒（DKA）和高渗性高血糖状态（HHS）是糖尿病的急性、危及生命的高血糖状况。我们的目的是评估DKA和HHS在2型糖尿病（T2D）合并心力衰竭（HF）患者的住院心血管结局，并比较这两种并发症。方法：使用全国住院患者样本数据库收集2008年至2019年因心力衰竭（原发性诊断）入院的T2D患者的数据。继发诊断为DKA或HHS。研究结果包括死亡率、缺血性中风、急性肾功能衰竭和心源性休克。结果：合并HHS-DKA的糖尿病HF患者比不合并HHS-DKA的患者更年轻，女性居多，冠状动脉疾病和慢性肾脏疾病患病率更高。DKA与较高的调整后死亡率（aOR = 2.75[2.42-3.13]）、缺血性卒中（aOR = 2.51[1.80-3.49]）、急性肾功能衰竭（aOR = 1.54[1.45-1.64]）和心源性休克（aOR = 2.53[2.19-2.92]）相关。合并HHS的糖尿病HF患者也比没有HHS- dka的患者更年轻，但有更多的合并症。然而，HHS仅与急性肾衰竭调整风险增加相关（aOR = 1.59[1.49-1.70]）。当两个高血糖组进行比较时，DKA患者更年轻，合并症更少。然而，他们有较高的调整后死亡率（aOR = 2.90[2.22-3.79]）和心源性休克（aOR = 2.86[2.13-3.83]），但没有出现急性肾衰竭或中风。结论：DKA和HHS与心力衰竭合并2型糖尿病患者更差的心血管结局相关。此外，当两种情况进行比较时，与HHS相比，DKA的死亡风险和心源性休克更高。实施量身定制的体液和电解质管理，优化胰岛素方案，加强监测和早期干预可以挽救这些高危患者的生命。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Cardiovascular Disorders CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.50

自引率

0.00%

发文量

480

审稿时长

1 months

期刊介绍： BMC Cardiovascular Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of disorders of the heart and circulatory system, as well as related molecular and cell biology, genetics, pathophysiology, epidemiology, and controlled trials.