A cross-sectional analysis of patient-based records on mortality among patients with diabetic ketoacidosis in a tertiary hospital in Ghana.

Yacoba Atiase, Josephine Akpalu, Ernest Yorke, Margaret Reynolds, Ofoliquaye Allotey Annan, Robert Aryee, Alfred Yawson
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Abstract

Objectives: To determine the mortality of patients admitted and managed for Diabetic ketoacidosis (DKA) at a teaching hospital.

Design: A cross-sectional study of the medical records of all 70 patients 18 years and older, managed for DKA in the adult emergency room of Korle-Bu Teaching Hospital in Ghana from March to July 2019.

Setting: The study was conducted among adult patients managed for diabetic ketoacidosis in the adult emergency room and adult medical wards of Korle-Bu Teaching Hospital.

Participants: The participants were patients aged 18 years or older who were admitted with diabetic ketoacidosis.

Interventions: Patients managed for diabetic ketoacidosis in the adult emergency room of Korle-Bu Teaching Hospital in Ghana had their outcomes assessed.

Main outcome measures: Outcomes of DKA management, including mortality, discharge, duration to either of these outcomes and associations were measured.

Results: The mortality rate from DKA in this study was 15.7%. Mean age, duration of diabetes, and blood glucose at admission were 44.06(±16.23) years, 7.19(±6.04) years, and 26.37(±6.70) mmol/L, respectively. Female gender and pulse rate >100 or <60 beats/minute were independently associated with mortality. Only 2 out of 70 (2.85%) patients were managed in the Intensive Care Unit (ICU).

Conclusion: The Mortality of DKA management in this hospital was high (15.7%). Most of these patients (97.15%) were not managed in the ICU or HDU; to improve this high mortality, there is a need to use the guidelines in the diagnosis, categorisation and management of DKA and to make the ICU and HDU available, accessible and affordable in our centre and elsewhere in Ghana.

Funding: None declared.

对加纳一家三级医院糖尿病酮症酸中毒患者死亡率记录的横断面分析。
目的:了解某教学医院收治的糖尿病酮症酸中毒(DKA)患者的死亡率。设计:对2019年3月至7月在加纳Korle-Bu教学医院成人急诊室为DKA管理的所有70名18岁及以上患者的医疗记录进行横断面研究。背景:研究对象为科尔布教学医院成人急诊室和成人病房治疗的糖尿病酮症酸中毒的成人患者。参与者:参与者为18岁及以上的糖尿病酮症酸中毒患者。干预措施:对加纳Korle-Bu教学医院成人急诊室处理的糖尿病酮症酸中毒患者的结局进行了评估。主要结果测量:测量DKA管理的结果,包括死亡率、出院、这些结果的持续时间和相关性。结果:本组DKA致死率为15.7%。患者入院时平均年龄为44.06(±16.23)岁,糖尿病病程为7.19(±6.04)岁,血糖为26.37(±6.70)mmol/L。结论:本院DKA治疗死亡率高(15.7%)。大多数患者(97.15%)未在ICU或HDU进行治疗;为了改善这种高死亡率,有必要在DKA的诊断、分类和管理中使用指南,并使ICU和HDU在我们中心和加纳其他地方可用、可获得和负担得起。资金:未宣布。
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