Predictors of five days mortality in diabetic ketoacidosis patients: a prospective cohort study.
OBJECTIVE
to determine the role of serum lactate and diabetic ketoacidosis (DKA) severity as predictors for five-days mortality in DKA patients.


METHODS
a prospective cohort study was conducted in DKA patients admitted to emergency department (ED) at Cipto Mangunkusumo Hospital, Jakarta, Indonesia, during 2007-2008 periods. Predictors for 5 days mortality in DKA patients in this study including serum lactate and DKA severity (plasma glucose, arterial blood pH, serum bicarbonate, osmolality, anion gap, and alteration in sensorium) at admission. Cox's Proportional Hazard Regression Analysis was used to determine independent predictors for 5-days mortality among study population.


RESULTS
sixty patients with diabetic ketoacidosis were enrolled in the study; in which 24 (40%) patients were died within 5 days after admission. In the multivariate analysis, the lactate level 4 mmol/L (HR, 3.09; 95% CI, 1.36-7.05) and altered in sensorium stuporous/comatose (HR, 3.38; 95% CI, 1.45-7.87) were identified as independent predictors for 5-days mortality in DKA adult patients.


CONCLUSIONS
lactate level 4 mmol/L and altered in sensorium stuporous/comatose can be used to predict 5-days mortality in adult patients with DKA.
Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Suhendro
S
Suwarto
Bambang
B
Sutrisna
Sarwono
S
Waspadji
Herdiman T
HT
Pohan
D000136:Acid-Base Equilibrium; D000328:Adult; D000368:Aged; D001639:Bicarbonates / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D003128:Coma / Q000209:etiology; D016883:Diabetic Ketoacidosis / Q000097:blood* / Q000150:complications / Q000401:mortality*; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000097:blood / Q000150:complications / Q000401:mortality*; D012720:Severity of Illness Index; D053608:Stupor / Q000209:etiology; D013997:Time Factors
D001639:Bicarbonates; D001786:Blood Glucose; D019344:Lactic Acid