PATTERN OF ADMISSION, TREATMENT OUTCOME AND ASSOCIATED FACTORS OF DIABETIC KETOACIDOSIS IN PATIENTS VISITED TO EMERGENCY DEPARTMENT OF HIWOT FANA COMPREHENSIVE SPECIALIZED HOSPITAL, HARAR, EASTERN ETHIOPIA.

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.