Treatment Outcome of Diabetic Ketoacidosis and its Determinants among Children Admitted in Debre-tabor and Gondar Referral Hospital Ethiopia: a Retrospective Study.
No Thumbnail Available
Date
2021-06
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Abeba University
Abstract
Background: -Diabetic ketoacidosis represents a state of acute metabolic stress that occurs due
to absolute or relative insulin deficiency for metabolism of glucose. It causes 0.15-0.35% death
of children in developed countries and 3.4-13.4% in developing countries.
Objective: To assess the treatment outcome of diabetic ketoacidosis and its determinants among
children with DKA in Debre-tabor and Gondar Referral Hospitals, North-West Ethiopia, 2021.
Methods: Institutional based retrospective cross sectional study was conducted with sample size
of 244. Systematic random sampling method was applied to select the study subject. The data
was collected by using checklist in the medical record. The collected data was coded and entered
in Epidata version 4.6 and was transferred to SPSS 25 for further analysis. Bivariate analysis was
done and all independent variables which have association with the outcome variable at p-value
0.25 were entered in to multivariable model. A p-value 0.05 was considered as a cut of value
to indicate statistical significance.
Result: In this study a total of 240 DKA children with response rate of 98.4%) were included.
From these, 86.7% of them recovered and 13.3% died. Respiratory tract infections (AOR=3.5;
95%CI;1.2-10), sepsis (AOR=4.9; 95%CI;1.45-16.57), cerebral edema (AOR=5.89;95%CI;1.5622.3),renal
failure (AOR=3.6;95%CI;1.06-12.45), hyponatremia (AOR=4;95%CI;1.02-16.1),
hypernatremia(AOR=7.4;95%CI;1.29-42.08),vomiting(AOR=3.4;95%CI;1.06-10.8),dehydration
(AOR=4; 95%CI;1.15-14.03) and not giving potassium replacement therapy (AOR=7.4;
95%CI;1.29-42.08) were significant associated factors for death of children with DKA.
Conclusion and recommendation
In general, the overall mortality of children with DKA was 13.3% in this study. The major
associated factors for death of children with DKA were vomiting, dehydration, hyponatremia/
hypernatremia, Respiratory tract infections, sepsis, renal failure, cerebral edema and potassium
therapy. So that early diagnosis and treatment of the above factors are necessary to prevent death
of children with DKA.
Description
Keywords
Diabetes mellitus, Diabetic Ketoacidosis, Risk Factors and Mortality