TREATMENT OUTCOMES AND ASSOCIATED FACTORS AMONG ADULT DIABETIC KETOACIDOSIS PATIENTS ADMITTED To EMERGENCY DEPARTMENT AT COMPREHENSIVE SPECIALIZED HOSPITALS NORTHWEST AMHARA, ETHIOPIA, 2022 ( RETROSPECTIVE CROSSECTIONAL STUDY)

Abstract

Abstract Introduction: Diabetic ketoacidosis is a community health problem associated with significant disability, morbidity, and mortality worldwide. According to International Diabetes Federation, the real prevalence of diabetic ketoacidosis is incognito. However, it was estimated to be around 24 percent. The majority of the patients are living in low-and middle-income countries. In Sub-Saharan Africa, particularly Ethiopia, the mortality rate is high among patients who are not detected and treated promptly. Objective: This study aimed to assess treatment outcomes and associated factors among adult Diabetic ketoacidosis patients admitted to the emergency department at Comprehensive Specialized Hospitals, Northwest Amhara Ethiopia 2022. Method: The multicenter institutional-based retrospective cross-sectional study design was conducted from May 14, 2017, to May 15, 2022, with a total sample size of 495 participants. A systematic random sampling method was used to choose study participants. Binary logistic regression models were fitted to identify associated factors with treatment outcomes. An adjusted odds ratio with 95% CI was computed and statistical significance was declared at (p<0.05). Result: The proportion of poor treatment outcomes was 5.1% (95% CI: 3.3%-7.6%). Patients being not insured (AOR=3.23; 95% CI: 1.14-9.13), fluid replacement (AOR=3.86; 95% CI: 1.17-12.72), Potassium replacement (AOR=3.84; 95% CI: 1.44-10.22) and time to recover from diabetic ketoacidosis (AOR=3.93; 95%CI: 1.31-11.81) were factors associated with poor treatment outcome of diabetic ketoacidosis. Conclusion and recommendation The Proportions of poor treatment outcomes among adult diabetic ketoacidosis patients in this study were low as compared to the previous studies. Not having health insurance, fluid replacement (<3liters), not replaced potassium, and time to recover from diabetic ketoacidosis (>72hours) were associated with poor treatment outcomes of diabetic ketoacidosis. Therefore, it would be better to provid fluid replacement, potassium replacement and reduce the time taken to get out of diabetic ketoacidosis. It is better to create awareness for the society to use health insurance. Keywords: Diabetic ketoacidosis, adult patients, treatment outcome and associated factors, Amhara, Ethiopia.