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  3. 25. Clinical Profile and Out Come of Diabetic Keto Acidosis in Emergency Department
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25. Clinical Profile and Out Come of Diabetic Keto Acidosis in Emergency Department

Niama Khan1, Haidar Zaman2, Mohsin Khan2, Faiza Khan3, Masroor Anwar4 and Mudassir Abdul Jalil Qureshi5

ABSTRACT

Objective: To ascertain the frequencies of presentations, biochemical profile compliance, comorbidities and outcomes of DKA, HHS and hypoglycemia.

Study Design: cross-sectional study

Place and Duration of Study: This study was conducted at emergency department of Ayub Teaching Hospital Abbottabad from June 2018 to December 2018.

Materials and Methods: All DKA, HHS and hypoglycemic patients presented in emergency department are included in study. We recorded demographic variables, clinical characteristics, chief complaints, comorbidities, hospital stay and outcome of complications. Anthropometric measures include pulse, blood pressure, respiratory rate, SPO2, GCS and temperature

Results: 197 diabetic patients were included in study. The mean age of sample was 53±18.84. 90/197 (45%) diabetic diagnosed individuals fulfilled HHS criteria. 57/197 patients (28%) met criteria of DKA, and 50/197 patients (25%) had hypoglycemia on presentation. The most common presentation of HHS and hypoglycemia was altered conscious level while majority of DKA were received in shock at presentation. The mean RBS of HHS, DKA, and hypoglycemic patients was 986mg/dl, 453mg/dl and 70mg/dl respectively. Glycosylated hemoglobin of HHS, DKA and hypoglycemia was 9.9, 9.4 and 6.5millimole respectively.  26 HHS patients died during management, 59 had comorbidities and common comorbidity was cardiovascular diseases (27%). 7 DKA patients died during management, 15 had underlying comorbidities. Renal comorbidities were commonly recorded. 2 hypoglycemic patients died during management, 28 had comorbidity and renal comorbidity was common. 81 HHS patients had poor compliance, 36 DKA had poor compliance and 19 hypoglycemics were poorly compliant to medications.

Conclusion: Highest mortality was recorded in HHS patients which is likely due to old age, cardiovascular comorbidities and poor compliance.

Key Words: Hypoglycemia, hyperosmolar hyperglycemic state (HHS), emergency department (ED), diabetic ketoacidosis (DKA), comorbidity, compliance

Citation of article: Khan N, Zaman H, Khan M, Khan F, Anwar M, Qureshi MAJ. Clinical Profile and Out Come of Diabetic Keto Acidosis in Emergency Department. Med Forum 2022;33(8):115-119.