Lee Cynthia, Szwak Jennifer Austin, Bastow Samantha, McCarthy Sarah
From the Howard University College of Pharmacy, Washington, DC.
University of Chicago Medicine, Chicago, Illinois.
J Patient Saf. 2020 Dec;16(4):e255-e259. doi: 10.1097/PTS.0000000000000647.
The aim of the study was to evaluate the impact of an insulin infusion calculator incorporated into electronic health record system in reducing the rate of hypoglycemia in diabetic ketoacidosis (DKA) management.
Retrospective chart review of patients with primary admission diagnosis of DKA was conducted in a university-affiliated academic medical center. End points including the rate of hypoglycemia, time to DKA resolution, rate of hypokalemia, time on insulin drip, and length of stay were measure before and after implementation of DKA calculator.
Of 181 adult patients admitted for primary diagnosis of DKA, 103 were managed using the calculator. After implementation of the calculator, incidence of hypoglycemia and severe hypoglycemia were significantly reduced by 70% and 87%, respectively (P < 0.01). No difference was observed for time to DKA resolution, time on insulin drip, and length of stay.
Implementation of DKA insulin infusion calculator significantly reduced the rate of hypoglycemia. Future improvements should focus on reducing time to DKA resolution and length of stay.
本研究旨在评估电子健康记录系统中纳入的胰岛素输注计算器对降低糖尿病酮症酸中毒（DKA）管理中低血糖发生率的影响。
在一所大学附属医院的学术医疗中心对初次入院诊断为DKA的患者进行回顾性病历审查。在实施DKA计算器前后，测量包括低血糖发生率、DKA缓解时间、低钾血症发生率、胰岛素输注时间和住院时间等终点指标。
在181例因DKA初次诊断入院的成年患者中，103例使用该计算器进行管理。计算器实施后，低血糖和严重低血糖的发生率分别显著降低了70%和87%（P < 0.01）。在DKA缓解时间、胰岛素输注时间和住院时间方面未观察到差异。
实施DKA胰岛素输注计算器显著降低了低血糖发生率。未来的改进应侧重于缩短DKA缓解时间和住院时间。
