Prognostic Factors in Patients Hospitalized with Diabetic Ketoacidosis
Endocrinology and Metabolism
; : 424-432, 2016.
Artigo
em Inglês
| WPRIM (Pacífico Ocidental)
| ID: wpr-105270
Biblioteca responsável:
WPRO
ABSTRACT
BACKGROUND:
Diabetic ketoacidosis (DKA) is characterized by a biochemical triad of hyperglycemia, acidosis, and ketonemia. This condition is life-threatening despite improvements in diabetic care. The purpose of this study was to evaluate the clinical and biochemical prognostic markers of DKA. We assessed correlations in prognostic markers with DKA-associated morbidity and mortality.METHODS:
Two hundred and seventy patients that were hospitalized with DKA over a period of 2 years were evaluated clinically and by laboratory tests. Serial assays of serum electrolytes, glucose, and blood pH were performed, and clinical outcome was noted as either discharged to home or death.RESULTS:
The analysis indicated that significant predictors included sex, history of type 1 diabetes mellitus or type 2 diabetes mellitus, systolic blood pressure, diastolic blood pressure, total leukocyte count, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, blood urea nitrogen, serum creatinine, serum magnesium, serum phosphate, serum osmolality, serum glutamic oxaloacetic transaminases, serum glutamic pyruvic transaminases, serum albumin, which were further regressed and subjected to multivariate logistic regression (MLR) analysis. The MLR analysis indicated that males were 7.93 times more likely to have favorable outcome compared with female patients (odds ratio, 7.93; 95% confidence interval, 3.99 to 13.51), while decreases in mean APACHE II score (14.83) and serum phosphate (4.38) at presentation may lead to 2.86- and 2.71-fold better outcomes, respectively, compared with higher levels (APACHE II score, 25.00; serum phosphate, 6.04).CONCLUSION:
Sex, baseline biochemical parameters such as APACHE II score, and phosphate level were important predictors of the DKA-associated mortality.
Texto completo:
Disponível
Contexto em Saúde:
ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis
Problema de saúde:
Diabetes Mellitus
/
Doenças do Sistema Endócrino
Base de dados:
WPRIM (Pacífico Ocidental)
Assunto principal:
Concentração Osmolar
/
Acidose
/
Pressão Sanguínea
/
Nitrogênio da Ureia Sanguínea
/
Albumina Sérica
/
Modelos Logísticos
/
Mortalidade
/
Cetoacidose Diabética
/
APACHE
/
Creatinina
Tipo de estudo:
Estudo prognóstico
/
Fatores de risco
Limite:
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Endocrinology and Metabolism
Ano de publicação:
2016
Tipo de documento:
Artigo