Predictors of Five Days Mortality in Diabetic Ketoacidosis Patients: a Prospective Cohort Study
ABSTRACT: to determine the
role of serum lactate and diabetic ketoacidosis (DKA) severity as predictors
for fvedays mortality in DKA patients. Methods: a prospective cohort study was
conducted in DKA patients admitted to emergency department (ED) at Cipto
Mangunkusumo Hospital, Jakarta, Indonesia, during 2007-2008 periods. Predictors
for 5 days mortality in DKA patients in this study including serum lactate and
DKA severity (plasma glucose, arterial blood pH, serum bicarbonate, osmolality,
anion gap, and alteration in sensorium) at admission. Cox’s Proportional Hazard
Regression Analysis was used to determine independent predictors for 5-days
mortality among study population. Results: sixty patients with diabetic
ketoacidosis were enrolled in the study; in which 24 (40%) patients were died
within 5 days after admission. In the multivariate analysis, the lactate level
≥4 mmol/L (HR, 3.09; 95% CI, 1.36-7.05) and altered in sensorium
stuporous/comatose (HR, 3.38; 95% CI, 1.45-7.87) were identifed as independent
predictors for 5-days mortality in DKA adult patients. Conclusion: lactate
level ≥4 mmol/L and altered in sensorium stuporous/comatose can be used to
predict 5-days mortality in adult patients with DKA.
Author: Suhendro Suwarto,
Bambang Sutrisna, Sarwono Waspadji, Herdiman T. Pohan
Journal Code: jpkedokterangg140267