Factors associated with prolonged intensive care unit treatment and organ failure in pediatric patients with diabetic ketoacidosis

Abstract

Context: Patients with diabetic ketoacidosis (DKA) have potential complications, such as respiratory failure, cerebral edema, or acute renal injury, all of which can lead to a prolonged hospital course. Aims: This study identified risk factors for prolonged intensive care unit (ICU) stay and organ failure in pediatric patients with DKA. Materials and Methods: Patients with DKA aged <19 years admitted to the pediatric ICU of our hospital between June 2011 and May 2021 were enrolled. Demographic characteristics, initial Glasgow Coma Scale score, source of admission, biochemical values, ICU length of stay (LOS), and hospital LOS were collected. The primary outcome was to identify factors associated with prolonged (≥48 h) ICU treatment. The secondary outcomes were to identify factors associated with respiratory failure, cerebral injury, or acute renal failure. Results: This study enrolled 137 patients. Nonemergency room admission was associated with longer ICU LOS [adjusted odds ratio (aOR), 3.14; 95% confidence interval (CI) 1.01–9.82] compared with admission from the emergency room. Older age (aOR, 0.89; 95% CI, 0.80–0.99) and underweight (aOR, 0.33; 95% CI, 0.12–0.95) were associated with shorter ICU LOS. Conclusions: Recognizing the risk factors associated with prolonged ICU LOS in pediatric patients with DKA may help clinicians with the early identification of critical DKA cases.