Factors affecting to the frequency of short-term adverse outcome in diabetic patients who are discharged from the emergency department

Patients with diabetic who have acute complications in the emergency department are excluded from the population aren't too low and need for correction of hyperglycemia in this group of patients should be discussed. There is no clear recommendation in the literature for the patient group who has been discharged. Treatments for lowering blood glucose levels to be applied in this area should be discussed with respect to the duration of emergency room, treatment costs and complications such as iatrogenic hypoglycaemia. We aimed to reveal the frequency and determinants of adverse events associated with hyperglycemia in patients with DM who were referred to our emergency department for any reason and who had been given a remote treatment decision. During the study, 342 patients were included in this study; patient was excluded because 49 (14.3%) patients had recurrent emergency department, 6 (1.7%) patients with missing data, 5 (1.4%) the main complaint of the patient is hypoglycaemia-related, 9 (2.6%) patients with diabetic acute complication and 44 (12.8%) patients were admitted to emergency services for other reasons. Of the included patients, 126 (55%) were female and the mean age was 58.9 (±12.6) years. Patients with plasma glucose levels 200 mg/d Land above had significantly higher mean waiting times for emergency care (p = 0.012, 95% GA 7.9-64.5). Similarly, the mean fluid replacement was greater in the group of 200 mg / dl (p= 0.002, 95% GA 121.6-521.6). Factors other than insulin-dependent diabetes mellitus (p= 0.015, OR 0.19, 95% CI 0.05-0.73) were predictive of recurrent admission in the first 7 days after admission to the diabetic patients who applied for emergency services; gender, age, admission and discharge glucose levels were not effective. Similarly, when assessed for the first 30 days, insulin-dependent diabetes was the only predictor (p= 0.008, OR 0.14 95% GA 0.03 - 0.60). As a result of our study, admission and discharge blood glucose levels, age, and gender factors measured in the emergency department are not determinative for short-term recurrent hospital admission in patients with diabetes who have not been diagnosed with acute complications. Should be careful evaluation and follow-up of Insulin-dependent diabetic patients with a high rate of recurrent admission and elderly diabetic patients whose hospitalization rates have increased compared to other diabetic patients. Key words: Emergency Department, Diabetes Mellitus, Hyperglycemia