title: Prognostic Factors in Patients Hospitalized with Diabetic Ketoacidosis.
abstract: BACKGROUND
  Diabetic ketoacidosis (DKA) is characterized by a biochemical triad of hyperglycemia, acidosis, and ketonemia. This condition is life-threatening despite improvements in diabetic care. The purpose of this study was to evaluate the clinical and biochemical prognostic markers of DKA. We assessed correlations in prognostic markers with DKA-associated morbidity and mortality.
  
  
  METHODS
  Two hundred and seventy patients that were hospitalized with DKA over a period of 2 years were evaluated clinically and by laboratory tests. Serial assays of serum electrolytes, glucose, and blood pH were performed, and clinical outcome was noted as either discharged to home or death.
  
  
  RESULTS
  The analysis indicated that significant predictors included sex, history of type 1 diabetes mellitus or type 2 diabetes mellitus, systolic blood pressure, diastolic blood pressure, total leukocyte count, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, blood urea nitrogen, serum creatinine, serum magnesium, serum phosphate, serum osmolality, serum glutamic oxaloacetic transaminases, serum glutamic pyruvic transaminases, serum albumin, which were further regressed and subjected to multivariate logistic regression (MLR) analysis. The MLR analysis indicated that males were 7.93 times more likely to have favorable outcome compared with female patients (odds ratio, 7.93; 95% confidence interval, 3.99 to 13.51), while decreases in mean APACHE II score (14.83) and serum phosphate (4.38) at presentation may lead to 2.86- and 2.71-fold better outcomes, respectively, compared with higher levels (APACHE II score, 25.00; serum phosphate, 6.04).
  
  
  CONCLUSIONS
  Sex, baseline biochemical parameters such as APACHE II score, and phosphate level were important predictors of the DKA-associated mortality.
authors: Department of Medicine, King George's Medical College, Lucknow, India.
authors: Avinash
authors: A
authors: Agarwal
authors: Department of Medicine, King George's Medical College, Lucknow, India.
authors: Ambuj
authors: A
authors: Yadav
authors: Department of Medicine, King George's Medical College, Lucknow, India. manish07gutch@gmail.com.
authors: Manish
authors: M
authors: Gutch
authors: Department of Obstetrics and Gynecology, King George's Medical College, Lucknow, India.
authors: Shuchi
authors: S
authors: Consul
authors: Department of Radiodiagnosis, King George's Medical College, Lucknow, India.
authors: Sukriti
authors: S
authors: Kumar
authors: Department of Pulmonary Medicine, King George's Medical College, Lucknow, India.
authors: Ved
authors: V
authors: Prakash
authors: Department of Physical Medicine and Rehabilitation, King George's Medical College, Lucknow, India.
authors: Anil Kumar
authors: AK
authors: Gupta
authors: Department of Medicine, King George's Medical College, Lucknow, India.
authors: Annesh
authors: A
authors: Bhattacharjee
keywords: Diabetic ketoacidosis; Hyperglycemia; Hyperglycemic hyperosmolar nonketotic coma; Ketosis