Outcome of Diabetic Keto Acidosis Treatment and Associated Factors Among Adult Patients Admitted to Emergency and Medical Wards at St. Paul’s Hospital, Addis Ababa Ethiopia, 2023: A Cross-Sectional Study

Abstract

Tsegamlak Kuemlachew Derse,1 Michael Tamene Haile,2 Tekalign Markos Chamiso3 1Department of Critical and Emergency Nursing, St. Paul’s Millennium Medical College, Addis Ababa, Ethiopia; 2Department of Pediatrics and Child Health Nursing, St. Paul’s Millennium Medical College, Addis Ababa, Ethiopia; 3Department of Cardiovascular Nursing, St. Paul’s Millennium Medical College, Addis Ababa, EthiopiaCorrespondence: Tsegamlak Kuemlachew Derse; Tekalign Markos Chamiso, St.Paul’s Hospital MMC, Addis Ababa, Ethiopia, Email [email protected]; [email protected]: Diabetic ketoacidosis is a potentially fatal disease that affects adults. Therefore, rapid detection and treatment are required to decrease mortality rates. Most of the earlier research on diabetic ketoacidosis in Ethiopia concentrated on its prevalence and associated factors. This study aimed to assess the treatment outcomes of diabetic ketoacidosis and its associated factors in adult patients admitted to St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, in 2023.Methods: This institution-based retrospective cross-sectional study was conducted with a sample size of 357. The data were entered in Epidata version 4.6 and exported to the Statistical Package for the Social Sciences (SPSS) version 25 for analysis. Adjusted Odds Ratio (AOR) with a 95% confidence interval was estimated to determine its association with outcome of treatment.Results: Three hundred fifty-seven diabetic ketoacidosis patients’ charts were reviewed. Fourteen (3.9%) diabetic ketoacidosis (DKA) patients had died. Those Patients with diabetic ketoacidosis who had acute comorbidity (presence of sepsis) (AOR = 3.24, 95% CI: 1.20– 10.2), international unit (IU) insulin administration in the 1st 24 hours (AOR = 8.046, 95% CI: 3.881– 25.32), fluid replacement in the 1st 24 hours (AOR = 5.84, 95% CI: 1.53– 10.07), and potassium replacement (AOR = 3.08, 95% CI: 1.835– 5.817) were independently associated with treatment outcome of diabetic ketoacidosis. Insulin administration for the first 24 hours more than > 60 IU insulin showed improvement in treatment outcome by 8.04 times more likely than less 6 liters fluid replacement in the first 24 hours had improvement in treatment outcome by 5.84 times more likely than < 6 liters fluid replacement.Conclusion: A considerable proportion of the patients with diabetic ketoacidosis died at St. Paul’s hospital millennium medical college. Stakeholders must emphasize the treatment of patients with diabetes (diabetic ketoacidosis), according to the recommendations of local and international guidelines.Keywords: morbidity, die, replacement, improvement and mortality

Keywords

• morbidity
• die
• replacement
• improvement and mortality