Treatment Outcome of Diabetic Ketoacidosis and its Determinants among Children Admitted in Debre-tabor and Gondar Referral Hospital Ethiopia: a Retrospective Study.

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Date

2021-06

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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.

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Keywords

Diabetes mellitus, Diabetic Ketoacidosis, Risk Factors and Mortality

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