Recurrent DKA results in high societal costs - a retrospective study identifying social predictors of recurrence for potential future intervention.

Clinical Diabetes and Endocrinology Pub Date : 2021-08-01 DOI:10.1186/s40842-021-00127-6

Ryan Lyerla, Brianna Johnson-Rabbett, Almoutaz Shakally, Rekha Magar, Hind Alameddine, Lisa Fish

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引用次数: 9

Abstract

Aims: Diabetic ketoacidosis (DKA) is an emergency with high morbidity and mortality. This study examined patient factors associated with hospitalization for recurrent DKA.

Methods: Characteristics of 265 subjects admitted for DKA at Hennepin County Medical Center between January 2017 and January 2019 were retrospectively analyzed. Differences between subjects with a single admission versus multiple were reviewed.

Results: Forty-eight out of 265 patients had recurrent DKA. Risk factors included African American race (adjusted odds ratio (aOR) versus white non-Hispanic = 4.6, 95% CI 1.8-13, p = 0.001) or other race/ethnicity (aOR = 8.6, 2.9-28, p < 0.0001), younger age (aOR 37-52y versus 18-36y = 0.48, 0.19-1.16, p = 0.10; aOR 53-99y versus 18-36y = 0.37, 0.12-0.99, p = 0.05), type 1 diabetes mellitus (aOR = 2.4, 1.1-5.5, p = 0.04), ever homeless (aOR = 2.5, 1.1-5.4, p = 0.03), and drug abuse (aOR = 3.2, 1.3-7.8, p = 0.009). DKA cost a median of $29,981 per admission.

Conclusions: Recurrent DKA is costly, and social determinants are strong predictors of recurrence. This study highlights the need for targeted preventative care programs.

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复发性DKA导致高社会成本-一项回顾性研究确定复发的社会预测因素，用于潜在的未来干预。

目的:糖尿病酮症酸中毒(DKA)是一种发病率和死亡率高的急症。本研究调查了与复发性DKA住院治疗相关的患者因素。方法:回顾性分析2017年1月至2019年1月在亨内平县医疗中心收治的265例DKA患者的特征。回顾了单次入院与多次入院受试者之间的差异。结果:265例患者中48例复发性DKA。危险因素包括非裔美国人种族(调整后的优势比(aOR)与非西班牙裔白人= 4.6,95% CI 1.8-13, p = 0.001)或其他种族/民族(aOR = 8.6, 2.9-28, p)。结论:复发性DKA代价高昂，社会决定因素是复发的有力预测因素。这项研究强调了有针对性的预防保健计划的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Diabetes and Endocrinology

自引率

0.00%

发文量

审稿时长

8 weeks

期刊介绍： Clinical Diabetes and Endocrinology is an open access journal publishing within the field of diabetes and endocrine disease. The journal aims to provide a widely available resource for people working within the field of diabetes and endocrinology, in order to improve the care of people affected by these conditions. The audience includes, but is not limited to, physicians, researchers, nurses, nutritionists, pharmacists, podiatrists, psychologists, epidemiologists, exercise physiologists and health care researchers. Research articles include patient-based research (clinical trials, clinical studies, and others), translational research (translation of basic science to clinical practice, translation of clinical practice to policy and others), as well as epidemiology and health care research. Clinical articles include case reports, case seminars, consensus statements, clinical practice guidelines and evidence-based medicine. Only articles considered to contribute new knowledge to the field will be considered for publication.