Abstract:
Background: Diabetic ketoacidosis is the most serious diabetic emergency in patients with type
1 and type 2 diabetes and it is the leading cause of mortality. There is limited data regarding
treatment outcomes and its predictors among hospitalized patients with diabetic ketoacidosis in
eastern Ethiopia. Therefore to fill this gap this study was conducted to assess pattern of
admission, treatment outcome and associated factors of diabetic ketoacidosis in emergency
departments of Hiwot Fana comprehensive specialized hospital, Harari regional state, eastern
Ethiopia.
Methods and Materials: Institutional based cross-sectional study was employed on 348
randomly selected patients with diabetic ketoacidosis and admitted to the emergency department
at Hiwot Fana comprehensive specialized hospital during the study period. Systematic random
sampling technique was employed and data were collected using a structured, standardized,
reliable and valid questionnaire adopted from previous studies. The collected data were entered
into EpiData Version 4.6 and exported to statistical package for social science version 25 for
analysis. All variables which have a P-value less than 0.25 in bivariable analysis were entered for
multivariable analysis and considered to be significantly associated if the P-value is less than
0.05.
Result: A total of 348 reviewed charts were collected. The mean age of patients was 34.99 ±
13.78 years. The most common precipitant factor of diabetic ketoacidosis was drug adherence
(132, 37.9 %). Nearly half of the patients (177, 50.9%) had more than or equal +3 urine ketone
level. About (312, 89.6%) hospitalized diabetic ketoacidosis patients have shown good treatment
outcomes, while (36, 10.3%) patients have shown poor treatment outcomes. Diabetic
ketoacidosis patients who had Glasgow coma scale value of 13-15 (AOR [95%] =2.168 [1.053,
6.510]), Patients who had mild (AOR [95%] =6.052 [2.330, 15.72]) and moderate (AOR [95%]
= 6.480 [2.279, 18.42]) Diabetic ketoacidosis had better treatment outcomes.
Conclusion and recommendation: The most common precipitant factor of diabetic ketoacidosis
was drug adherence. Treatment outcome is significantly associated with low levels of Glasgow
coma scale and severity of diabetic ketoacidosis. So it is recommended that health education
about drug adherence and overall comprehensive diabetic care during illness is needed to reduce
hospital mortality.
