| Title |
Functional outcome of patients with prolonged hypoglycemic encephalopathy
|
|---|---|
| Published in |
Annals of Intensive Care, May 2017
|
| DOI | 10.1186/s13613-017-0277-2 |
| Pubmed ID | |
| Authors |
Guillaume Barbara, Bruno Mégarbane, Laurent Argaud, Guillaume Louis, Nicolas Lerolle, Francis Schneider, Stéphane Gaudry, Nicolas Barbarot, Angéline Jamet, Hervé Outin, Sébastien Gibot, Pierre-Edouard Bollaert |
| Abstract |
Little is known about the causes, clinical course and long-term outcome of comatose patients with prolonged hypoglycemic encephalopathy. In a multicenter retrospective study conducted in patients hospitalized from July 1, 2004, to July 1, 2014, we investigated functional long-term prognosis and identified prognosis factors of patients admitted in an intensive care unit (ICU) with prolonged neurological manifestations related to hypoglycemia. Eligible patients were adults admitted to the ICU with a Glasgow Coma Score <8 due to hypoglycemia and persistent consciousness disorders after normalizing blood glucose levels. Patients with possible other causes of consciousness disorders, previous cognitive disorders, hypothermia <35 °C or circulatory arrest within 24 h after ICU admission, were excluded. Follow-up phone call was used to determine patients' functional outcome using modified Rankin Scale (mRS) at a minimum of 1-year follow-up with mRS 0-3 defining good and mRS 4-6 poor outcomes. Forty-nine patients were included. Causes of hypoglycemia were various, mainly including insulin or oral antidiabetic drugs abuse (65%) and neuroendocrine carcinoma (16%). Twenty (41%) patients died in the ICU, two (4%) patients further died and nine (18%) patients had a poor outcome at long-term follow-up. Five patients discharged from the ICU with mRS > 3 improved enough to be in the good outcome group 1 year later. Twenty-two (45%) patients underwent therapeutic limitation, mainly related to no expected hope for improvement. On multivariate analysis, only low mRS prior to ICU admission (OR 2.6; 95% CI 1.1-6.3; P = 0.03) and normal brain imaging (OR 7.1; 95% CI 1.1-44; P = 0.03) were significantly predictive of a good outcome. All patients (n = 15) who remained hypoglycemic >480 min had a poor outcome. Poor outcome was observed in about 60% of this population of hypoglycemic encephalopathy. However, some patients can recover satisfactorily over time. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | 50% |
| Unknown | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 48 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 48 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 9 | 19% |
| Researcher | 6 | 13% |
| Student > Bachelor | 5 | 10% |
| Professor | 3 | 6% |
| Student > Doctoral Student | 3 | 6% |
| Other | 11 | 23% |
| Unknown | 11 | 23% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 23 | 48% |
| Neuroscience | 6 | 13% |
| Biochemistry, Genetics and Molecular Biology | 2 | 4% |
| Nursing and Health Professions | 2 | 4% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 2% |
| Other | 4 | 8% |
| Unknown | 10 | 21% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 31 July 2019.
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#14,811,692
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Outputs from Annals of Intensive Care
#786
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#184,688
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Outputs of similar age from Annals of Intensive Care
#21
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