Dataset Information

Risk of death following admission to a UK hospital with diabetic ketoacidosis.

ABSTRACT:

Aims/hypothesis

The aim of this study was to assess the risk of death during hospital admission for diabetic ketoacidosis (DKA) and, subsequently, following discharge. In addition, we aimed to characterise the risk factors for multiple presentations with DKA.

Methods

We conducted a retrospective cohort study of all DKA admissions between 2007 and 2012 at a university teaching hospital. All patients with type 1 diabetes who were admitted with DKA (628 admissions of 298 individuals) were identified by discharge coding. Clinical, biochemical and mortality data were obtained from electronic patient records and national databases. Follow-up continued until the end of 2014.

Results

Compared with patients with a single DKA admission, those with recurrent DKA (more than five episodes) were diagnosed with diabetes at an earlier age (median 14 [interquartile range 9-23] vs 24 [16-34] years, p?Conclusions/interpretationRecurrent DKA is associated with substantial mortality, particularly among young, socially disadvantaged adults with very high HbA1c levels.

SUBMITTER: Gibb FW

PROVIDER: S-EPMC5016550 | biostudies-literature | 2016 Oct

REPOSITORIES: biostudies-literature

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Publications

Risk of death following admission to a UK hospital with diabetic ketoacidosis.

Gibb Fraser W FW Teoh Wei Leng WL Graham Joanne J Lockman K Ann KA

Diabetologia 20160711 10

<h4>Aims/hypothesis</h4>The aim of this study was to assess the risk of death during hospital admission for diabetic ketoacidosis (DKA) and, subsequently, following discharge. In addition, we aimed to characterise the risk factors for multiple presentations with DKA.<h4>Methods</h4>We conducted a retrospective cohort study of all DKA admissions between 2007 and 2012 at a university teaching hospital. All patients with type 1 diabetes who were admitted with DKA (628 admissions of 298 individuals) ...[more]

PMID: 27397023

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Project description:Background: This study aimed to understand the impact of a critical care admission on long-term outcomes, compared to other hospitalised patients without a critical care encounter. A secondary aim was to examine the interrelationship between emotional, physical, and social problems during recovery.Methods: We utilised data from the UK Biobank, an on-going, prospective population-based cohort study. We employed propensity score matching to assess differences in outcomes between patients with a critical care encounter and patients admitted to the hospital (first admission to hospital available) without critical care. Structural equation modelling was used to analyse emotional, physical and social outcomes following critical illness and the relationships between these health domains.Findings: Data from 1,618 patients were analysed. The median time to follow-up in the critical care cohort was 4427 days (IQR:788-6146) vs 4516 days (IQR: 811-6369) in the non-critical care, hospitalised cohort. Across the two time periods assessed (pre and post 2000), patients exposed to critical care were more likely to experience mental health issues such as depression (p < 0.01) and social isolation (p = 0.01) following discharge from hospital. The critical care cohort were also more likely to have social problems such as the requirement for government funded welfare support (p = 0.02). In the critical care cohort, social and emotional health were closely correlated (p < 0.001, 95% CI:0.33-0.54). The nature of physical problems changed over time; pre-2000 there was a significant difference between the critical and non-critical care in physical outcomes following discharge from hospital, however, there was no difference detected between the two cohorts post-2000.InterpretationThis cohort study has demonstrated that survivors of critical illness have different psycho-social outcomes to matched patients, hospitalised without a critical care encounter.FundingJM is funded by a THIS.Institute (University of Cambridge) Research Fellowship (PD-2019-02-16). AHL is part of the Social and Public Health Sciences Unit, funded by the Medical Research Council (MC_UU_12017/13) and the Scottish Government Chief Scientist Office (SPHSU13).

Dataset Information

Risk of death following admission to a UK hospital with diabetic ketoacidosis.

Aims/hypothesis

Methods

Results

Publications

Risk of death following admission to a UK hospital with diabetic ketoacidosis.

Similar Datasets

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