Mamo Shimeles Tefera, Gebretensaye Tigistu Gebreyohannis, Mulugeta Feven, Bekele Gemechu Gelan
Department of Nursing, College of Medicine and Health Sciences, Madda Walabu University, Goba Referral Hospital, Oromia, Ethiopia.
School of Nursing and Midwifery College of Health Science, Addis Ababa University, Ethiopia.
SAGE Open Med. 2025 May 26;13:20503121251343175. doi: 10.1177/20503121251343175. eCollection 2025.
Diabetic ketoacidosis, a severe complication of type 1 diabetes, remains a major cause of morbidity and mortality in children, particularly in resource-limited settings such as Ethiopia. Despite its high burden, data on recovery time and predictors of diabetic ketoacidosis in this population are scarce. Therefore, this study aimed to assess the time to recovery from diabetic ketoacidosis and its predictors among children with diabetic ketoacidosis at selected governmental hospitals in Addis Ababa, Ethiopia.
A 5-year retrospective follow-up study was conducted among 391 hospitalized children with diabetic ketoacidosis in selected governmental hospitals in Addis Ababa, from January 1, 2018 to December 30, 2022. Participants and hospitals were selected using a simple random sampling method. A structured data collection checklist was adapted from similar studies and modified. The data were checked for completeness and entered into Stata version 16 for analysis. Variables with -value < 0.05 in the multivariate Cox proportional hazards model were considered significant predictors of the time to recovery from diabetic ketoacidosis.
A total of 423 records of children with diabetic ketoacidosis with 391 (92.4%) response rates were included in the final analysis. Out of these, 370 were recovered and discharged. The remaining 21 cases were censored. The overall median time taken to resolution from diabetic ketoacidosis was 27 h, with an interquartile range of 16-38. Diabetic mellitus history (Adjusted Hazard Ratio (AHR) = 0.41, 95% CI: 0.30-0.56), severity of diabetic ketoacidosis (AHR = 2.35, 95% CI: 1.34-6.1), presence of comorbidity (AHR = 1.76, 95% CI: 1.37-2.26), and blood sugar level (AHR = 0.61, 95% CI: 0.39-0.96) were all independent predictors of time to recovery from diabetic ketoacidosis.
The median diabetic ketoacidosis recovery time was 27 h. Key predictors included admission glucose, comorbidities, diabetic ketoacidosis severity, and diabetes history. Early diagnosis, thorough assessment, and optimized management are crucial to reducing risks and improving outcomes.
糖尿病酮症酸中毒是1型糖尿病的一种严重并发症，仍然是儿童发病和死亡的主要原因，特别是在埃塞俄比亚等资源有限的地区。尽管其负担沉重，但关于该人群糖尿病酮症酸中毒恢复时间和预测因素的数据却很少。因此，本研究旨在评估埃塞俄比亚亚的斯亚贝巴选定政府医院中糖尿病酮症酸中毒儿童的恢复时间及其预测因素。
对2018年1月1日至2022年12月30日期间在亚的斯亚贝巴选定政府医院住院的391例糖尿病酮症酸中毒儿童进行了为期5年的回顾性随访研究。采用简单随机抽样方法选择参与者和医院。从类似研究中改编并修改了一份结构化数据收集清单。检查数据的完整性，并输入Stata 16版本进行分析。多变量Cox比例风险模型中P值<0.05的变量被认为是糖尿病酮症酸中毒恢复时间的重要预测因素。
最终分析纳入了423例糖尿病酮症酸中毒儿童的记录，回复率为391例（92.4%）。其中，370例康复出院。其余21例被审查。糖尿病酮症酸中毒总体中位恢复时间为27小时，四分位间距为16 - 38小时。糖尿病病史（调整后风险比（AHR）=0.41，95%置信区间：0.30 - 0.56）、糖尿病酮症酸中毒严重程度（AHR = 2.35，95%置信区间：1.34 - 6.1）、合并症的存在（AHR = 1.76，95%置信区间：1.37 - 2.26）和血糖水平（AHR = 0.61，95%置信区间：0.39 - 0.96）均为糖尿病酮症酸中毒恢复时间的独立预测因素。
糖尿病酮症酸中毒中位恢复时间为27小时。关键预测因素包括入院时血糖、合并症、糖尿病酮症酸中毒严重程度和糖尿病病史。早期诊断、全面评估和优化管理对于降低风险和改善结局至关重要。
