Morbimortality Analysis of Diabetic Ketoacidosis in a Second Level Hospital in Mexico

Abstract

Background: Diabetic ketoacidosis (DKA) is a very frequent entity that presents as an acute complication of diabetes mellitus, in which there is a state of hyperglycemia, metabolic acidosis and ketosis. Acute complications of diabetes represent a high percentage of admissions to the emergency department of second level hospitals in Mexico. Methods: This is a retrospective, observational, comparative, cohort and descriptive study with documented analysis technique. We obtained information from a diary of records of the intensive care unit of our hospital and included all patients older than 14 years with a diagnosis of diabetic ketoacidosis. Patients younger than 14 years were excluded as well as hyperosmolar states. Results: Of the 1725 patients admitted to the ICU only 134 had diabetic ketoacidosis; 91% of which were of metabolic origin; 3 patients had acute pancreatitis, and complications were equal to 0.7%, being acute renal injury, urosepsis, preeclampsia and pneumonia. The most frequent age group was between 20 and 30 years old, while mortality was 10%. The incidence of diabetic ketoacidosis was more frequent in the male sex in contrast with the study of Li et al who report a predominance in the female sex. In the age group we agree with Ramphul et al. who determine an average age of 18 to 44 years in the U.S. population. Therefore, we take into account that our casuistry in Mexico is partially similar and that the tendency of diabetic ketoacidosis has been greater in the male population, as well as an increased mortality. Conclusions: In this study involving patients with diabetic ketoacidosis, the incidence and mortality tend to be increasing in our hospital and is that related to economic and sociocultural factors given the fact that our country and hospital of origin is in the means of development.