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Abstract
Objective: To study the outcome of patients admitted with DKA in the Pediatric Intensive Care Unit (PICU) and the factors affecting it.
Methods: It was a prospective study, conducted in the Pediatric Intensive Care Unit of the University of Child Health Sciences & The Children’s Hospital, Lahore, from June 2019 to July 2022. Data was collected on well well-designed form. Patients who were admitted to the PICU with DKA were enrolled in the study. Data was analyzed using SPSS version 25. Chi-square test was used to find out the p-value.
Results: In this study, 165 patients were enrolled, from June 2019 to July 2022, with a mean age of 7.88±3.97yrs years. Forty-four patients (26.7%) presented in moderate DKA, while 73.3%(n=121) presented in severe DKA. Ninety-five patients (57.6%) had new-onset diabetes. Among already known cases, 50.3%(n=83) had poor glycemic control. Mean hospital stay was 5.0 ±2.4 days. Moderate cases recovered within 24-36 hours of hospital stay, while severe cases took 5-7 days to recover completely. Mortality was seen in 23.6%(n=39) while 76.3%(n=126) recovered. Conscious level, pH at admission, hypernatremia, pulmonary edema, cerebral edema, refractory shock, need for mechanical ventilation, and dialysis were the factors that were strongly associated with the outcome of DKA patients (p <0.001).
Conclusion: The more severe the presentation of DKA, the greater the chances of complications and worse outcomes. Altered conscious level, pH<7 at admission, hypernatremia, pulmonary edema, cerebral edema, refractory shock, need for mechanical ventilation, and peritoneal dialysis were the factors associated with poor outcome.
Keywords: Diabetic Ketoacidosis, Treatment outcome, Risk factors, Pediatric ICU
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