INCIDENCE AND PREDICTORS OF MORTALITY AMONG CHILDREN WITH DIABETIC KETOACIDOSIS IN WEST AMHARA REGION REFFERAL HOSPITALS, NORTHWEST ETHIOPIA: A RETROSPECTIVE FOLLOW-UP STUDY

Abstract

Abstract Introduction: Diabetic ketoacidosis is one of the major life-threatening condition of acute metabolic complications. It remains a major public health problem in developing countries including Ethiopia. There are limited studies about mortality among children with diabetic ketoacidosis in Ethiopia. Therefore, this study aimed to fill the information gap which shows burden of mortality among children related to diabetic ketoacidosis and increase the survival status of children. Objective: The aim of this study was to assess incidence and predictors of mortality among children with diabetic ketoacidosis in West Amhara region Comprehensive Specialized Referral Hospitals, Northwest Ethiopia, 2022. Methods: An institution-based retrospective follow-up study was conducted from 423 study participants with confirmed diagnosis of diabetic ketoacidosis from January 1 2017 to December 31 th , 2021. The response rate was 95 %. The sample were selected through a simple random sampling technique. Data were entered, coded and cleaned, and checked by Epi-Data statistical software version 4.6 and exported to Stata version 14 statistical software for data analysis. Descriptive statistics such as, frequency, percentage, tables, and figures were used to present result. Kaplan-Meier curve was used to estimate survival time and to compare the survival curve among different categories. The log-rank test was employed to look at statistical differences between categories of variables. Those variables with P- Value ? 0.25 for Bi-variable candidate for multivariable and P-value ? 0.05 for multivariable was used to declare a statistically significant association with the outcome variable. Result: A total of 401 children records were included in in the final analysis and observed for 3781 days follow up period. The overall mortality of children with diabetic ketoacidosis was 10.6 per 1000 person-days observation with (95 % CI: 7.8-14.4) during the entire follow-up period. Hypoglycemia (AHR=4.6; 95 % CI: 2.13-10.1), residency of rural (AHR=2.9; 95 % CI=1.01-8.11), age less than five years (AHR=4.4; 95 % CI=1.4-13.7), age five up to ten (AHR=3.1; 95 % CI=1.1-8.8) and being female (AHR=2.6; 95 % CI=1.15.8) were significantly associated with diabetic ketoacidosis mortality.

Conclusion: The current study showed that the incidence rate of mortality among children with diabetic ketoacidosis was relatively high. Age, child from rural residency, being female, and hypoglycemia were significant predictors of mortality. Keywords: Diabetic Ketoacidosis, Mortality, Predictors, Survival status