Τίτλος:
A mortality prediction model in diabetic ketoacidosis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
AIM To assess the value of clinical and laboratory parameters in
predicting mortality in patients presenting with diabetic ketoacidosis
(DKA).
METHODS The records of all DKA admissions within 10 years were reviewed.
Eighteen variables were evaluated at initial presentation and 20
variables at 4, 12 and 24 h from admission. A scoring system derived
from these variables was compared to the APACHE III scoring system.
RESULTS Among 154 patients (52 males, mean age 58 +/- 12 years), 20
(13%) died in hospital. Multivariate analysis yielded six variables as
significant independent predictors ( P < 0.05) of mortality: severe
coexisting diseases (SCD) and pH < 7.0, at presentation; units of
regular insulin required in the first 12 h > 50 and serum glucose > 16.7
mmo/l, after 12 h; depressed mental state and fever, after 24 h. An
integer-based scoring system was derived, as follows: number of points =
6 (SCD at presentation) + 4 (pH < 7.0 at presentation) + 4 (regular
insulin required > 50 IU after 12 h) + 4 (serum glucose > 16.7 mmo/l
after 12 h) + 4 (depressed mental state after 24 h) + 3 (fever after 24
h). Patients with 0-14 points had 0.86% risk of death, whereas for
those with 19-25 points the risk was 93.3%. Median APACHE III scores
differed significantly ( P < 0.001) among groups of patients stratified
according to the above scoring system.
CONCLUSIONS Risk stratification of patients with diabetic ketoacidosis
is possible from simple clinical and laboratory variables available
during the first day of hospitalization.
Συγγραφείς:
Efstathiou, SP
Tsiakou, AG
Tsioulos, DI
Zacharos, ID and
Mitromaras, AG
Mastorantonakis, SE
Panagiotou, TN and
Mountokalakis, TD
Περιοδικό:
Clinical Endocrinology
Εκδότης:
Wiley-Blackwell Publishing Ltd
DOI:
10.1046/j.1365-2265.2002.01636.x
