Clinical and Epidemiological Characteristics of Diabetic Ketoacidosis in Older Adults
© 2020 The American Geriatrics Society..
OBJECTIVES: Much of the research previously done on diabetic ketoacidosis (DKA) was based on a young population with type 1 diabetes mellitus (type 1 DM). But substantial numbers of DKA episodes occur in patients with a prior history of type 2 diabetes mellitus (type 2 DM). There is a lack of Data are lacking about DKA in older adults. The aims of this study were to analyze the clinical characteristics and outcomes of older adult patients with DKA.
DESIGN: Retrospective matched cohort study of adult patients hospitalized with DKA between 2004 and 2017.
SETTING: Soroka University Medical Center, Be'er Sheva, Israel.
PARTICIPANTS: The clinical characteristics of DKA patients 65 years and older were compared with patients younger than 65 years.
MEASUREMENTS: The primary outcome was in-hospital mortality.
RESULTS: The study cohort included 385 consecutive patients for whom the admission diagnosis was DKA: 307 patients (79.7%) younger than 65 years (group 1), and 78 patients (20.3%) older than 65 years (group 2). Patients in group 2 compared with group 1 had a significantly higher Charlson index (6 [6-6] vs 6 [6-7]; P < .0001) and DM with target organ damage (24.4% vs 6.2%; P < .0001). Patients in group 2 compared with group 1 had more serious disease according to results of laboratory investigations. The total in-hospital mortality rate of patients in group 2 was 16.7% compared with 1.6% in patients in group 1 in a sex and co-morbidities matched analysis (P = .001).
CONCLUSIONS: DKA in older adults is a common problem. The serious co-morbidities and precipitating factors such as infection/sepsis, myocardial infarction, and cerebrovascular accidents, may explain the severity of the problem of DKA in older adults and the high rate of mortality of these patients. DKA appears to be a lifethreatening condition in older adults. The alertness of physicians to DKA in older adults, timely diagnosis, proper treatment, and prevention are cornerstones of care. J Am Geriatr Soc 68:1256-1261, 2020.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:68 |
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| Enthalten in: |
Journal of the American Geriatrics Society - 68(2020), 6 vom: 15. Juni, Seite 1256-1261 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Schwarzfuchs, Dan [VerfasserIn] |
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| Links: |
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| Themen: |
Clinical characteristics |
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| Anmerkungen: |
Date Completed 02.03.2021 Date Revised 02.03.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/jgs.16376 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM307251403 |
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| 245 | 1 | 0 | |a Clinical and Epidemiological Characteristics of Diabetic Ketoacidosis in Older Adults |
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| 500 | |a Date Revised 02.03.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020 The American Geriatrics Society. | ||
| 520 | |a OBJECTIVES: Much of the research previously done on diabetic ketoacidosis (DKA) was based on a young population with type 1 diabetes mellitus (type 1 DM). But substantial numbers of DKA episodes occur in patients with a prior history of type 2 diabetes mellitus (type 2 DM). There is a lack of Data are lacking about DKA in older adults. The aims of this study were to analyze the clinical characteristics and outcomes of older adult patients with DKA | ||
| 520 | |a DESIGN: Retrospective matched cohort study of adult patients hospitalized with DKA between 2004 and 2017 | ||
| 520 | |a SETTING: Soroka University Medical Center, Be'er Sheva, Israel | ||
| 520 | |a PARTICIPANTS: The clinical characteristics of DKA patients 65 years and older were compared with patients younger than 65 years | ||
| 520 | |a MEASUREMENTS: The primary outcome was in-hospital mortality | ||
| 520 | |a RESULTS: The study cohort included 385 consecutive patients for whom the admission diagnosis was DKA: 307 patients (79.7%) younger than 65 years (group 1), and 78 patients (20.3%) older than 65 years (group 2). Patients in group 2 compared with group 1 had a significantly higher Charlson index (6 [6-6] vs 6 [6-7]; P < .0001) and DM with target organ damage (24.4% vs 6.2%; P < .0001). Patients in group 2 compared with group 1 had more serious disease according to results of laboratory investigations. The total in-hospital mortality rate of patients in group 2 was 16.7% compared with 1.6% in patients in group 1 in a sex and co-morbidities matched analysis (P = .001) | ||
| 520 | |a CONCLUSIONS: DKA in older adults is a common problem. The serious co-morbidities and precipitating factors such as infection/sepsis, myocardial infarction, and cerebrovascular accidents, may explain the severity of the problem of DKA in older adults and the high rate of mortality of these patients. DKA appears to be a lifethreatening condition in older adults. The alertness of physicians to DKA in older adults, timely diagnosis, proper treatment, and prevention are cornerstones of care. J Am Geriatr Soc 68:1256-1261, 2020 | ||
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| 650 | 4 | |a outcomes | |
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| 700 | 1 | |a Sagy, Iftach |e verfasserin |4 aut | |
| 700 | 1 | |a Zimhony-Nissim, Noa |e verfasserin |4 aut | |
| 700 | 1 | |a Lipnitzki, Inna |e verfasserin |4 aut | |
| 700 | 1 | |a Musa, Hadeel |e verfasserin |4 aut | |
| 700 | 1 | |a Jotkowitz, Alan |e verfasserin |4 aut | |
| 700 | 1 | |a Brandstaetter, Evgenia |e verfasserin |4 aut | |
| 700 | 1 | |a Barski, Leonid |e verfasserin |4 aut | |
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