Related factors of mortality for patients with diabetic ketoacidosis / 中华内分泌外科杂志

ABSTRACT

Objective To study the factors related to the mortality of diabetic ketoacidosis (DKA).Methods From Jan.2011 to Dec.2015,109 hospitalized patients with diabetic ketoacidosis were selected as the subjects,which included 39 cases of type 1 diabetes and 70 cases of type 2 diabetes.DKA patients were aging from 20 to 45 years,including 39 males and 70 females,with the average age of 42.The death group had 17 cases,including 6 males and 11 females with the average age of 56.The survival group had 92 cases,including 33 males and 59 females,with the average age of 41.Age,12 h blood glucose,sex,12 h disturbance of consciousness,BMI,hypernatremia,12 h shock,hyperlipidemia,12 h insulin dosage,hyperkalemia,fever,diabetes mellitus,family history of diabetes,infection and the combined use of basic disease were sorted out and analyzed.Results Among the 109 patients with DKA,17 died and the mortality rate was 15.6％.The causes of deaths included acute myocardial infarction in 4 cases,left ventricular dysfunction in 5 cases,3 case of cardiac arrest,acute renal insufficiency in 3 case,and cerebrovascular disease in 3 case.Univariate regression analysis showed that age,12h blood glucose,12h disturbance of consciousness,12h shock,12h insulin dosage,infection,combined with underlying diseases may be risk factors for DKA patients with poor prognosis.Multivariate logistic analysis showed that age(OR=2.954,95％ CI3.081-8.261,P=0.002),12 h blood glucose ＜16.7 mmol/L (OR=1.592,95％ CI1.915-4.920,P=0.006),infection (OR=2.621,95％ CI1.814-3.945,P=0.030),combined with underlying disease (OR=2.913,95％ CI3.014-9.405,P=0.000)were independent risk factors for DKA mortality.Conclusion By stratifying the mortality risk of DKA patients,the prognosis of DKA patients can be improved rationally and effectively.