埃塞俄比亚中部公立医院15岁以下儿童糖尿病酮症酸中毒的发病率及预测因素：一项回顾性队列研究

Incidence and Predictors of Diabetic Keto-acidosis Among Children Under 15 Years At Central Ethiopia Public Hospital A Retrospective Cohort Study.

作者信息

Sebro Sisay Foga, Saliya Sentayehu Admasu, Ashine Taye Mezgebu, Heliso Asnakech Zekiwos, Dodo Habtamu Demisse, Gebre Kinfemicheal Melaku, Alaro Micheal Geletu, Mamo Seifu Awgchew, Biranu Muluneh Bethelhem, Kechine Tibore Temesgen, Babore Getachew Ossabo, Abdisa Elias Nigusu

机构信息

Department of Pediatrics and Child Health Nursing, College of Medicine and Health Science, Wachemo University, Hosanna, Ethiopia.

Department of Comprehensive Nursing, College of Medicine and Health Science, Wachemo University, Hosanna, Ethiopia.

出版信息

Clin Med Insights Pediatr. 2025 Aug 14;19:11795565251349122. doi: 10.1177/11795565251349122. eCollection 2025.

DOI:10.1177/11795565251349122

PMID:40821447

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12354998/

Abstract

BACKGROUND

Diabetic ketoacidosis (DKA) is the most serious acute complication of type 1 diabetes mellitus. pediatrics with an incidence rate of 1% to 10% per patient, children have the possibility of dying due to cerebral edema and have significant mortality and morbidity. Diabetic ketoacidosis is unfortunately becoming more common in African nations due to insufficient public healthcare systems.

OBJECTIVE

The objective is to assess the Incidence and Predictors of Diabetic Keto-acidosis Among Children Under 15 Years At Central Ethiopia Public Hospital in A Retrospective Cohort Study 2022.

METHODS

Wachemo University Specialized Hospital in Hadiya Zone, central Ethiopia, recruited 390 children with diabetes mellitus.

DESIGN

It is a retrospective cohort study. The time frame for the study was January 1, 2018, through December 30, 2021. Predictors of diabetic ketoacidosis were examined using the Cox proportional hazard model. In the end, the Cox-regression hazard model contained predictors whose hazard ratio, 95% confidence interval (CI), and -value were less than .25 in the bivariable analysis. Statistically significant at a -value of less than .05.

RESULT

A total of 378 child records were examined, yielding a 96.92% response rate. 207 (54.8%) of the 378 recruited children experienced DKA, with a mean follow-up period of 20.83 months and a 95% CI = (49.72, 59.80; 19.54, 22.12). In the cohort, there were 26 incidences of DKA for every 1000 children per month. The following factors were reported to be substantially linked with diabetic ketoacidosis: age <5 years AHR = 2.5 (1.61-3.86), living in a rural location AHR = 1.48 (1.02-2.16), co-morbidity AHR = 1.51 (1.10-2.08), and missed DM follow-up AHR = 1.6 (1.17-2.18).

CONCLUSION

In this study, the incidence of diabetic ketoacidosis was seen in over half of the children. Intervention strategies and early patient identification at risk for this increased incidence of diabetic ketoacidosis.

摘要

背景

糖尿病酮症酸中毒（DKA）是1型糖尿病最严重的急性并发症。在儿科患者中，发病率为1%至10%，儿童有因脑水肿死亡的可能性，且死亡率和发病率都很高。不幸的是，由于公共医疗系统不足，糖尿病酮症酸中毒在非洲国家正变得越来越普遍。

目的

目的是在一项2022年的回顾性队列研究中，评估埃塞俄比亚中部公立医院15岁以下儿童糖尿病酮症酸中毒的发病率及预测因素。

方法

埃塞俄比亚中部哈迪亚地区的瓦切莫大学专科医院招募了390名糖尿病儿童。

设计

这是一项回顾性队列研究。研究的时间范围是2018年1月1日至2021年12月30日。使用Cox比例风险模型检查糖尿病酮症酸中毒的预测因素。最后，Cox回归风险模型包含在双变量分析中风险比、95%置信区间（CI）和P值小于0.25的预测因素。P值小于0.05具有统计学意义。

结果

共检查了378份儿童记录，应答率为96.92%。在378名招募的儿童中，207名（54.8%）发生了糖尿病酮症酸中毒，平均随访期为20.83个月，95%CI =（49.72，59.80；19.54，22.12）。在该队列中，每月每1000名儿童中有26例糖尿病酮症酸中毒发生。据报告，以下因素与糖尿病酮症酸中毒密切相关：年龄<5岁，调整后风险比（AHR）=2.5（1.61 - 3.86）；居住在农村地区，AHR = 1.48（1.02 - 2.16）；合并症，AHR = 1.51（1.10 - 2.08）；错过糖尿病随访，AHR = 1.6（1.17 - 2.18）。