Suwarto Suhendro, Sutrisna Bambang, Waspadji Sarwono, Pohan Herdiman T
Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Acta Med Indones. 2014 Jan;46(1):18-23.
to determine the role of serum lactate and diabetic ketoacidosis (DKA) severity as predictors for five-days mortality in DKA patients.
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.
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 identified as independent predictors for 5-days mortality in DKA adult patients.
lactate level 4 mmol/L and altered in sensorium stuporous/comatose can be used to predict 5-days mortality in adult patients with DKA.
确定血清乳酸水平及糖尿病酮症酸中毒（DKA）严重程度作为DKA患者5天死亡率预测指标的作用。
对2007 - 2008年期间在印度尼西亚雅加达西托·芒古库苏莫医院急诊科收治的DKA患者进行一项前瞻性队列研究。本研究中DKA患者5天死亡率的预测指标包括入院时的血清乳酸水平及DKA严重程度（血糖、动脉血pH值、血清碳酸氢盐、渗透压、阴离子间隙及意识改变）。采用Cox比例风险回归分析确定研究人群中5天死亡率的独立预测指标。
60例糖尿病酮症酸中毒患者纳入研究；其中24例（40%）患者在入院后5天内死亡。多因素分析中，乳酸水平≥4 mmol/L（HR，3.09；95%CI，1.36 - 7.05）及意识改变为昏迷/昏睡（HR，3.38；95%CI，1.45 - 7.87）被确定为DKA成年患者5天死亡率的独立预测指标。
乳酸水平≥4 mmol/L及意识改变为昏迷/昏睡可用于预测成年DKA患者的5天死亡率。
