Risk Factors for Adverse Outcomes in Children With Diabetic Ketoacidosis
Authors' conclusion
Type 2 diabetes and severity of initial hyperglycemia and acidosis are independent risk factors for Adverse Outcomes and explain the higher frequency of Adverse Outcomes during the COVID-19 pandemic. Risks decreased in January 2022 to June 2023.
Study context
- Population
- Admissions of children with diabetic ketoacidosis (DKA) and/or hyperglycemic hyperosmolar state (HHS) to a large academic children's hospital, January 2010 to June 2023 (4284 DKA alone, 31 [0.7%] only HHS, 250 [5.4%] hyperosmolar DKA)
- Participants
- 4,565 admissions
- Exposure
- 2010-2019 vs 2020-2021 vs 2022-2023
- 2010-2019n = 3,004
- 2020-2021n = 903
- 2022-2023n = 658
- Outcome
- Composite Adverse Outcome:
- Death
- ICU stay > 48 hours
Methodological detailssingle-centre, multivariable prediction model, training and validation datasets
- Single-centre
- Multivariable prediction model
- Training and validation datasets
Main finding
As reported in the abstract
Discrimination of multivariable model (max serum glucose, initial pH, T2D) for composite Adverse Outcome
| Group | AUC |
|---|---|
| 2010-2019 | 0.948 |
| 2020-2021 | 0.960 |
| 2022-2023 | 0.873 |
AUC
2010-20190.948
2020-20210.960
2022-20230.873
Observational data: associations, not effects.
Further findings
Admissions with Adverse Outcomes
Death
- Patients died
- 8 (0.18%)
- AUC for death, full dataset
- 0.984
Proportion with T2D
- Proportion of patients with T2D was highest in 2020-2021
Original publication
Risk Factors for Adverse Outcomes in Children With Diabetic Ketoacidosis. J Clin Endocrinol Metab. Published 20 July 2024. doi:10.
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