title: Precipitating factors, outcomes, and recurrence of diabetic ketoacidosis at a university hospital in Damascus.
abstract: OBJECTIVE
  To study precipitating factors, outcomes, and recurrence of diabetic ketoacidosis (DKA) at a University hospital at Damascus, the capital of Syria.
  
  
  METHODS
  Medical records between 2006 and 2012 were reviewed. One hundred and fifteen admissions for 100 patients with DKA were included. All fulfilled the American Diabetic Association DKA diagnostic criteria.
  
  
  RESULTS
  Of 115 admissions of DKA, there were 92 single admission and 23 recurrent admissions (eight patients). The order of precipitating factors of recurrent DKA or single admissions were the same with different percentage. The first and second factors were infection (74% and 48%) and treatment problems (17% and 24%), respectively. Complications rate was significantly higher in the intensive care unit (41.6%), compared to the ward admissions (14.2%). Overall in-hospital mortality rate was 11.3%. The severity of medical conditions that provoke DKA with aging, not the metabolic complications of hyperglycemia or ketoacidosis, were behind this high mortality rate. Patients who died were significantly (P = 0.004) older than patients who were discharged alive.
  
  
  CONCLUSIONS
  Results concerning precipitating factor were similar to the results of many other studies. However, mortality rate was higher which might be explained by the severity of underlying precipitating illness.
authors.affiliation: Department of Internal Medicine, Damascus University, Damascus, Syria ; Faculty of Medicine, Damascus University, Damascus, Syria.
authors.forename: Zaynab
authors.initials: Z
authors.lastname: Alourfi
authors.affiliation: Faculty of Medicine, Damascus University, Damascus, Syria.
authors.forename: Hakam
authors.initials: H
authors.lastname: Homsi
keywords: DKA; DKA outcomes; DKA precipitating factor; DKA recurrence; Diabetic ketoacidosis