Use of beta-hydroxybutyric acid levels in the emergency department.
The impact of a new test on the market, the beta-hydroxybutyric acid (BOH) assay, on clinical decision-making in the emergency department (ED) has not been well studied. In this retrospective analysis, we studied the potential benefit of this new test in the ED decision-making process in diabetic patients. BOH levels were measured on all patients who had glucose and acetone levels ordered by the emergency physician during a 3-month period in the ED of a university tertiary referral center. Two groups were analyzed: group 1 was acetone-positive and BOH-positive (n = 13); group 2 was acetone-negative BOH-positive (n = 31). There was no difference between the two groups in terms of gender (p = 0.55) or age (p = 0. 47). The length of stay (p = 0.97) and number of complications (p = 0.89) were also similar between the two groups.


CONCLUSIONS
This study suggests that in those diabetic patients with a negative acetone test and a positive BOH test, the addition of the positive result on the BOH test may provide additional prognostic information for predicting hospital length of stay and number of in-hospital complications.
Timmons
J A
JA
Section of Emergency Medicine, Rush-Presbyterian-St.Luke's Medical Center, Chicago, IL 60612, USA.
Myer
P
P
Maturen
A
A
Webster
R
R
Schaller
E
E
Leikin
J
J
Barkin
R
R
D020155:3-Hydroxybutyric Acid / Q000097:blood*; D000096:Acetone / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D016883:Diabetic Ketoacidosis / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D004638:Emergency Treatment / Q000379:methods*; D005230:Fatty Acids, Nonesterified / Q000378:metabolism; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008099:Liver / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D000096:Acetone; D020155:3-Hydroxybutyric Acid