Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya.
J Diabetes Res. 2020 Oct 20;2020:8987403. doi: 10.1155/2020/8987403. eCollection 2020.
Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication that mainly occurs in patients with type 1 diabetes mellitus and is the foremost cause of death in these children. Overall mortality in children with DKA varies from 3.4% to 13.4% in developing countries. There is a need to understand outcomes among children with DKA in sub-Saharan African countries.
To determine the death rate and clinical outcomes of children and adolescents aged 0-18 years managed for DKA at Kenyatta National Hospital (KNH). . This was a retrospective study carried out among children aged 0-18 years admitted with DKA at KNH between February 2013 and February 2018. The study site was the central records department at KNH. The inclusion criteria were children aged 0-18 years admitted with a diagnosis of DKA based on the ISPAD guidelines biochemical criteria.
Out of the 159 files reviewed, the median age of children was 13 years (IQR 10-15). 41.1% of patients had severe DKA while 35.7% had moderate DKA. We reported a mortality of 6.9% while 93.1% of children recovered and were discharged home. The median duration of hospital stay was 8 days. High risk of mortality was reported among children who had high serum creatinine (OR 5.8 (95% CI 1.6-21.2)), decreased urine output (OR 9.0 (95% CI 2.2-37.3)), and altered level of consciousness (OR 5.2 (95% CI 1.1-25.1)).
DKA-associated mortality in our study was low at 6.9%. High serum creatinine, decreased urine output, and altered level of consciousness were associated with a significantly higher risk of mortality.
糖尿病酮症酸中毒（DKA）是一种急性、严重、危及生命的并发症，主要发生在 1 型糖尿病患者中，是这些儿童死亡的首要原因。在发展中国家，DKA 患儿的总体死亡率在 3.4%至 13.4%之间。有必要了解撒哈拉以南非洲国家 DKA 患儿的结局。
确定在肯尼亚国家医院（KNH）接受 DKA 治疗的 0-18 岁儿童和青少年的死亡率和临床结局。这是一项回顾性研究，在 2013 年 2 月至 2018 年 2 月期间，在 KNH 因 DKA 住院的 0-18 岁儿童中进行。研究地点是 KNH 的中央记录处。纳入标准为根据 ISPAD 生化标准诊断为 DKA 并入住 KNH 的 0-18 岁儿童。
在审查的 159 份档案中，儿童的中位数年龄为 13 岁（IQR 10-15）。41.1%的患者为重度 DKA，35.7%的患者为中度 DKA。我们报告的死亡率为 6.9%，而 93.1%的儿童康复并出院回家。住院时间中位数为 8 天。血清肌酐升高（OR 5.8（95%CI 1.6-21.2））、尿量减少（OR 9.0（95%CI 2.2-37.3））和意识水平改变（OR 5.2（95%CI 1.1-25.1））的儿童报告有较高的死亡风险。
我们的研究中，DKA 相关死亡率为 6.9%，较低。高血清肌酐、尿量减少和意识水平改变与死亡率显著升高相关。
