2021年埃塞俄比亚西北部住院儿童糖尿病酮症酸中毒的治疗结果及其决定因素：一项回顾性横断面研究

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie Pub Date : 2025-05-01 DOI:10.1016/j.arcped.2024.11.011

Mequanint Ayehu Akele , Rajalakshmi Murugan , Feven Mulugeta , Tamalew Alemie Tegegne

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引用次数: 0

摘要

背景：糖尿病酮症酸中毒（DKA）仍然是发展中国家儿童死亡的主要原因。目的：评估埃塞俄比亚西北部住院儿童DKA的治疗结果及其决定因素。方法：对240例DKA患儿进行了一项以机构为基础的回顾性横断面研究。我们通过使用检查表回顾患者病历来收集5年的数据。使用双变量和多变量模型来确定自变量与结果变量的关联。经多元回归，p < 0.05为有统计学意义。结果：纳入研究的240例DKA患儿中，86.7%康复，13.3%死亡。呼吸道感染(调整后优势比[AOR] = 3.5；95%可信区间[CI]: 1.2-10)、脓毒症(AOR = 4.9；95% CI: 1.45-16.57)，脑水肿(AOR = 5.89；95% CI: 1.56-22.3)，肾功能衰竭(AOR = 3.6；95% CI:1.06-12.45)，低钠血症(AOR = 4；95% CI:1.02-16.1)，高钠血症(AOR = 7.4；95% CI:1.29-42.08)、脱水(AOR = 4；95% CI: 1.15-14.03)，未接受钾替代治疗(AOR = 7.4；95% CI: 1.29-42.08)是与死亡显著相关的因素。结论：本研究中DKA患儿的总死亡率为13.3%。与死亡相关的主要因素是脱水、低钠血症或高钠血症、呼吸道感染、败血症、肾功能衰竭和脑水肿。因此，早期诊断和治疗这些因素对于降低DKA患儿的死亡率是必要的。

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Treatment outcome of diabetic ketoacidosis and its determinants among children admitted to hospitals in northwest Ethiopia in 2021: A retrospective cross-sectional study

Background

Diabetic ketoacidosis (DKA) remains a leading cause of death among children in developing countries.

Objectives

To assess the treatment outcome of DKA and its determinants among children admitted to hospitals in northwest Ethiopia.

Methods

An institutional-based, retrospective cross-sectional study was conducted among 240 children with DKA. We collected 5-year data by reviewing patient charts using a checklist. Bivariate and multivariate models were used to determine the association of the independent variables with the outcome variable. After multivariate regression, a value of p < 0.05 was considered statistically significant.

Result

Of the 240 children with DKA included in the study, 86.7 % recovered and 13.3 % died. Respiratory tract infections (adjusted odds ratio [AOR] = 3.5; 95 % confidence interval [CI]: 1.2–10), sepsis (AOR = 4.9; 95 % CI: 1.45–16.57), cerebral edema (AOR = 5.89; 95 % CI: 1.56–22.3), renal failure (AOR = 3.6; 95 % CI:1.06–12.45), hyponatremia (AOR = 4; 95 % CI:1.02–16.1), hypernatremia (AOR = 7.4; 95 % CI:1.29–42.08), dehydration (AOR = 4; 95 % CI: 1.15–14.03), and not receiving potassium replacement therapy (AOR = 7.4; 95 % CI: 1.29–42.08) were factors significantly associated with death.

Conclusion

In this study, the overall mortality of children with DKA was 13.3 %. The major factors associated with death were dehydration, hyponatremia or hypernatremia, respiratory tract infections, sepsis, renal failure, and cerebral edema. Thus, early diagnosis and treatment of these factors are necessary to decrease mortality in children with DKA.

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来源期刊

Archives De Pediatrie 医学-小儿科

CiteScore

2.80

自引率

5.60%

发文量

106

审稿时长

24.1 weeks

期刊介绍： Archives de Pédiatrie publishes in English original Research papers, Review articles, Short communications, Practice guidelines, Editorials and Letters in all fields relevant to pediatrics. Eight issues of Archives de Pédiatrie are released annually, as well as supplementary and special editions to complete these regular issues. All manuscripts submitted to the journal are subjected to peer review by international experts, and must: Be written in excellent English, clear and easy to understand, precise and concise; Bring new, interesting, valid information - and improve clinical care or guide future research; Be solely the work of the author(s) stated; Not have been previously published elsewhere and not be under consideration by another journal; Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. Archives de Pédiatrie is the official publication of the French Society of Pediatrics.