印度尼西亚巴厘岛一家三级转诊医院的糖尿病酮症酸中毒患者概况

Noviana Joenputri
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摘要

介绍。糖尿病酮症酸中毒(DKA)是一种以高血糖、酮症和酸中毒为特征的危及生命的急性糖尿病并发症。糖尿病的患病率正在增加,因此DKA的发病率预计将继续增加。本研究的目的是获得RSUP中DKA患者的概况。作为巴厘和努沙登加拉地区的三级转诊医院。方法。本研究为队列回顾性研究。所有在RSPN于2022年1月至2023年2月期间诊断为DKA的18岁及以上患者均被纳入本研究。数据从医疗记录中获取,然后使用SPSS version 26程序进行分析。结果。共41例DKA患者,平均年龄50,59 (SD 16,87)岁,以女性居多(51.2%),无转诊单独就诊(58.5%)。根据临床资料,大多数患者表现为意识下降(36.5%),感染(90.2%),主要是尿路感染(40.5%),有胰岛素使用史(34.1%),肾功能受损(85.4%)。血糖平均值为468,95 (SD 207,78) mg/dL,钾水平为4,19 (SD 1,17) mmol/L,碳酸氢盐水平为12,85 (SD 6,27) mmol/L,糖化血红蛋白为11.5%(7,1-14)。中位住院时间为7(1-30)天,19.5%的患者在治疗期间死亡,多数在治疗前72小时内死亡。结论。本研究患者多为年龄小于60岁的女性。最常见的诱发DKA的因素是尿路感染和血糖控制不良。在本研究中,共有19.5%的DKA患者去世。因此,临床医生应该更积极地管理DKA,特别是在最初的72小时内。
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Profil Pasien Ketoasidosis Diabetikum di Rumah Sakit Rujukan Tersier di Bali, Indonesia
Introduction. Diabetic ketoacidosis (DKA) is one of life-threatening acute complication of diabetes mellitus (DM) characterized by hyperglycemia, ketosis, and acidosis. The prevalence of DM is increasing, therefore the incidence of DKA is predicted to continue to increase. The aim of this study was to obtain the profile of DKA patients in RSUP Prof. Dr. IGNG. Ngoerah (RSPN), Denpasar, Bali as a tertiary refferal hospital of Bali and Nusa Tenggara region. Methods. This study was a cohort retrospective study. All patients aged 18 years or older with a diagnosis of DKA during Januari 2022 to February 2023 at RSPN, were included in this study. Data were obtained from medical records then analyzed using the SPSS version 26 program. Results. There were a total of 41 patients with DKA with mean of age was 50,59 (SD 16,87) years, most of them were female (51,2%) and came alone without referral (58,5%). Based on the clinical profile, most patients presented with decreased consciousness (36,5%), infection (90,2%) mostly urinary tract infection (UTI) (40,5%), have a history of insulin use (34,1%), and impaired of renal function (85,4%). The mean of blood glucose was 468,95 (SD 207,78) mg/dL, potassium level 4,19 (SD 1,17) mmol/L, bicarbonate level 12,85 (SD 6,27) mmol/L, and HbA1c 11,5% (7,1-14). The median duration of hospitalization was 7 (1-30) days and 19,5% of them were passed away during treatment, mostly within the first 72 hours. Conclusions. Most patients in this study are female with age less than 60 years. The most common precipitating factor of DKA are UTI and poor glycemic control. A total of 19,5% of patients with DKA were passed away in this study. Thus, clinicians should be more aggressive in the management of DKA, particularly in the first 72 hours.
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