DOI: 10.21276/ijlssr.2016.2.3.10
ABSTRACT- Introduction: Paediatric Diabetic Ketoacidosis (DKA) studies are limited in Asia and none have
investigated markers of disease severity or prolonged hospital Length Of Stay (LOS). We investigate predictors of disease
severity and prolonged hospital LOS by analysing the demographics and signs and symptoms of patients with DKA.
Methods: We conducted a retrospective study of the medical records of patients who presented to the emergency
department of a tertiary paediatric hospital in Singapore between 2012 and 2013 and were diagnosed with DKA, obtaining
demographics, signs, symptoms, serum pH levels, precipitating causes, and hospital LOS for the 67 eligible patients.
Results: 82.1% of patients were tachycardic, 44.8% tachypneic and 20.9% febrile; none were hypotensive. The most
common symptoms were nausea and vomiting (56.7%), polyuria and polydipsia (50.7%), lethargy (34.3%), and fever
(22.4%).Half had mild DKA (48.5%) while a quarter of patients each had moderate (24.2%) and severe DKA (27.3%). A
higher proportion of those with severe DKA presented with tachypnea (p=.007). Prolonged LOS patients were younger at
presentation (p = .010), and a higher proportion had no prior history of DM (p=.061), presented with polyuria or
polydipsia (p=.062) and had a lower pH on presentation (p=.056).
Conclusions: Paediatric patients with DKA present with non-specific symptoms. Patients with tachypnea were more
likely to have a worse disease severity. Younger patients, those without a history of DM, or had lower serum pH, and
polyuria and polydipsia were more likely to have a prolonged hospital LOS.
Key-words- Diabetic Ketoacidosis,Child;Emergency Medicine, Length of Stay, Severity of Illness Index