P. Raffoul, G. Ishak, A. Hazimeh and Y. Hazimeh (2025). Predictors of prolonged hospital length of stay and mortality in adult patients with diabetic ketoacidosis in Lebanon: a monocentric retrospective study. Journal of diabetes and metabolic disorders, 24(1), 35. https://doi.org/10.1007/s40200-024-01554-9

PubMed 39764474

[Abstract]
OBJECTIVES: Diabetic ketoacidosis (DKA) is an acute complication in patients who suffer from diabetes mellitus that could progress to fatal outcomes if not identified and treated promptly. DKA poses a substantial impact on healthcare systems. In this study, we aim to identify the predictors of prolonged hospital length of stay (LOS) and mortality in patients admitted with DKA.

METHODS: This retrospective monocentric observational study was conducted in Lebanon. It analyzed data extracted from electronic medical records of a sample of adult patients admitted with DKA to a tertiary care center in Lebanon from 2006 to 2023. Multiple linear and logistic regressions were used to identify predictors of hospital LOS and in-hospital mortality, respectively.

RESULTS: A total of 147 patients were included in the analysis, including 64 males (43.5%) and 83 females (56.5%). The median age was 38 years. The median LOS at the hospital for patients with DKA was 7 days (IQR = 4.00-11.00). The in-hospital mortality rate was found to be 18.4%. Multiple linear regression showed that age was the only significant predictor of LOS at the hospital, with a regression coefficient of 0.171 (p = 0.012). Multiple logistic regression analysis revealed that age, intubation, and vasopressor use were significant predictors of in-hospital mortality.

CONCLUSION: Our study investigated the LOS and mortality in patients with DKA in a tertiary institution in Lebanon and found an alarmingly high mortality rate and that LOS was only dependent on age, while mortality could only be predicted by age, intubation, and vasopressor use. This indicates opportunities to further examine modifiable institutional and socioeconomic factors that go beyond the patients' clinical characteristics to implement effective solutions that reduce LOS and mortality in DKA patients.