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- 저자 : Manish Gutch (검색결과 1 건)
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Prognostic Factors in Patients Hospitalized with Diabetic Ketoacidosis
Avinash Agarwal,Ambuj Yadav,Manish Gutch,Shuchi Consul,Sukriti Kumar,Ved Prakash,Anil Kumar Gupta,Annesh Bhattacharjee 대한내분비학회 2016 Endocrinology and metabolism Vol.31 No.3
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 andbiochemical prognostic markers of DKA. We assessed correlations in prognostic markers with DKA-associated morbidity andmortality. Methods: Two hundred and seventy patients that were hospitalized with DKA over a period of 2 years were evaluated clinically andby laboratory tests. Serial assays of serum electrolytes, glucose, and blood pH were performed, and clinical outcome was noted aseither 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 glutamicoxaloacetic transaminases, serum glutamic pyruvic transaminases, serum albumin, which were further regressed and subjected tomultivariate logistic regression (MLR) analysis. The MLR analysis indicated that males were 7.93 times more likely to have favorableoutcome compared with female patients (odds ratio, 7.93; 95% confidence interval, 3.99 to 13.51), while decreases in meanAPACHE 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 theDKA-associated mortality.
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