Öz
Giriş
Diyabet mellituslu (DM) pediatrik hastalarda diyabetik ketoasidozun (DKA) varlığı ve şiddeti ile ilişkili kapsamlı hasta özelliklerini tanımlamayı amaçladık.
Gereç ve Yöntem
Bu retrospektif, tek merkezli çalışmaya DM’li pediatrik hastalar dahil edildi. Hastalar DKA’lı ve DKA’sız olarak kategorize edildi ve DKA’lı hastalar hafif, orta ve şiddetli olarak alt gruplara ayrıldı. Klinik semptomlar, biyokimyasal parametreler ve yoğun bakım ünitesi (YBÜ) ihtiyacı dahil tedavi gereksinimleri değerlendirildi. Veriler elektronik tıbbi kayıtlardan elde edildi ve analizler DKA’lı ve DKA’sız hastalar ile DKA şiddet grupları arasındaki karşılaştırmaları içerdi.
Bulgular
Çalışmaya 150 hastanın 180 başvurusu dahil edildi ve bunların 84’ü (%46,7) DKA ile ilişkiliydi. DKA’sız hastalara kıyasla, DKA’lı hastalarda karın ağrısı (p=0,048), yorgunluk (p=0,011), kusma (p<0,001), bulantı (p=0,021), letarji (p=0,046) ve taşipne (p=0,006) sıklığı daha yüksekti. Ayrıca, önceki DKA öyküsü (p<0,001), aktif enfeksiyon (p=0,011), tip 1 DM (p=0,015) ve YBÜ yatışı (p=0,020) daha yaygındı. DKA’lı hastalarda kan şekeri (p<0,001), kreatinin (p=0,009) ve lökosit sayısı (p<0,001) daha yüksekken, sodyum (p=0,045) ve potasyum (p=0,018) daha düşüktü. Şiddetli DKA’lı hastalarda, hafif ve orta DKA’lı hastalara kıyasla daha yüksek lökosit sayısı (p=0,001) seviyeleri vardı. Ayrıca, ketoasidoz süresi daha uzun (p<0,001) ve YBÜ yatışı daha sıktı (p=0,020). Lojistik regresyon analizi sonuçlarına göre, kusma (p<0.001) ve önceki DKA geçmişi (p<0.001) DKA için bağımsız risk faktörleriydi. Şiddetli DKA için ise yorgunluk (p=0.031) bağımsız bir risk faktörüydü.
Sonuç
Bu çalışma, DKA’lı pediatrik hastalarla ilgili kapsamlı bir veri seti sunmakta ve DKA ile şiddetiyle ilişkili çok sayıda faktörü tanımlamaktadır.
Anahtar Kelimeler: Anahtar kelimeler: Diyabetik ketoasidoz, tip 1 diabetes mellitus, pediatri, metabolik bozukluklar, yoğun bakım üniteleri
Kaynakça
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