The evaluation of the effect of demographic, clinical and laboratory properties on prognosis in the application of diabetic ketoasiodos in the children intensive care unit

Objective: The aim of this study was to investigate the relationship between the demographic, clinical and laboratory characteristics of the patients admitted to the PICU with the DKA diagnosis and the time to transition to subcutaneous treatment, as well as to guide the physicians in predicting the DKA prognosis and to contribute to the literature. Method: Twenty-seven DKA patients followed-up in the PICU of Adiyaman University Education and Research Hospital between 2013-2018 were included in the study. The files of these patients were retrospectively analyzed and demographic data, clinical and laboratory features were recorded. As a prognostic factor; time to subcutaneous insulin was accepted. The effects of the obtained data on the time to transition to subcutaneous insulin were examined. Results: Of the 27 patients included in our study, 9 (33.3%) were female and 18 (66.7%) were male. The mean age of the patients was 9.3 ± 3.41 years. In the past history, the time to transition to subcutaneous insulin was significantly longer in patients with a family history of DM (p=0,037). Altered consciousness (p=0,006), respiratory distress (p=0,047), and acetone odor in the mouth (p = 0.039) were significantly longer in patients with complaints of clinical features. The duration of transition to subcutaneous insulin was found to be significantly longer in patients with severe DKA coma grade (p=0,018). A positive correlation was found between the PRISM score used in the intensive care unit and the transition time to subcutaneous insulin (r=0,584, p=0,002). There was a negative correlation between the pH values of the patients at the time of admission (r= -0,616, p=0,001) and HCO3 (r = -0,552, p=0,005). Conclusion: Our findings at the time of application; changes in consciousness, respiratory distress, acetone odor in the mouth, high PRISM score, heavy DKA coma in children with severe acidosis in blood gas, the prognosis will be worse and the transition time to subcutaneous insulin will be longer. Key words: Diabetes mellitus, diabetic ketoacidosis, prognostic factors, children