Situation and Correlation Between Outcomes and Severity of Diabetic Ketoacidosis at Phra Nakhon Si Ayutthaya Hospital in 2022

Abstract

Objective: Diabetic ketoacidosis is acute life-threatening complication of diabetes mellitus and also important health burden in Thailand, affected mortality and resource expenditure. The objective was to study situation, mortality rate and correlation between outcomes and severity of diabetic ketoacidosis at Phra Nakhon Si Ayutthaya hospital in 2022. Methods: A single center, retrospective cohort study was collected data from 5,193 hospitalized diabetes patients aged more than 15 years old, included by criteria according to American Diabetes Association at Phra Nakhon Si Ayutthaya hospital in 2022. Results: The rate of hospitalization for DKA was 2.5 per 100 persons with diabetes mellitus. 130 patients were enrolled with mean age 52.9 years (SD=19), mean height 159.6 centimeters (SD=11), mean body mass index 23.5 kilograms per square meter (SD=5). The female accounted more than male in all the groups. Patient with type 2 diabetes mellitus accounted mostly for 73.9% of all the patients. First diagnosed diabetes mellitus accounted for 10.8% presented with diabetic ketoacidosis. Hypertension is the most common underlying disease, second one is dyslipidemia. The mean duration of stay was 10.8 days (SD=12.3). The occurrence of acute kidney injury was 45.4%. The requirement of intensive care unit was 12.3% and needed invasive ventilation 36.2%. The mortality rate was higher in this study 24.6% compared with the previous study. Conclusion: The mortality rate, intensive care unit stay and requiring invasive ventilation was found correlated significantly with severity of diabetic ketoacidosis  (p-value 0.021, 0.049, <0.001 respectively). From this study, the author concern about health burden of the patients and we should encourage and develop the care of patients with diabetic ketoacidosis in Phra Nakhon Si Ayutthaya hospital to decrease the life-threatening complication, mortality and promote the good quality of life.