MA. Akele, R. Murugan, F. Mulugeta and TA. Tegegne (2025). Treatment outcome of diabetic ketoacidosis and its determinants among children admitted to hospitals in northwest Ethiopia in 2021: A retrospective cross-sectional study. Archives de pediatrie : organe officiel de la Societe francaise de pediatrie, 32(4), 266-271. https://doi.org/10.1016/j.arcped.2024.11.011

PubMed 40199693

[Abstract]
BACKGROUND: Diabetic ketoacidosis (DKA) remains a leading cause of death among children in developing countries.

OBJECTIVES: To assess the treatment outcome of DKA and its determinants among children admitted to hospitals in northwest Ethiopia.

METHODS: An institutional-based, retrospective cross-sectional study was conducted among 240 children with DKA. We collected 5-year data by reviewing patient charts using a checklist. Bivariate and multivariate models were used to determine the association of the independent variables with the outcome variable. After multivariate regression, a value of p < 0.05 was considered statistically significant.

RESULT: Of the 240 children with DKA included in the study, 86.7 % recovered and 13.3 % died. Respiratory tract infections (adjusted odds ratio [AOR] = 3.5; 95 % confidence interval [CI]: 1.2-10), sepsis (AOR = 4.9; 95 % CI: 1.45-16.57), cerebral edema (AOR = 5.89; 95 % CI: 1.56-22.3), renal failure (AOR = 3.6; 95 % CI:1.06-12.45), hyponatremia (AOR = 4; 95 % CI:1.02-16.1), hypernatremia (AOR = 7.4; 95 % CI:1.29-42.08), dehydration (AOR = 4; 95 % CI: 1.15-14.03), and not receiving potassium replacement therapy (AOR = 7.4; 95 % CI: 1.29-42.08) were factors significantly associated with death.

CONCLUSION: In this study, the overall mortality of children with DKA was 13.3 %. The major factors associated with death were dehydration, hyponatremia or hypernatremia, respiratory tract infections, sepsis, renal failure, and cerebral edema. Thus, early diagnosis and treatment of these factors are necessary to decrease mortality in children with DKA.