2289-P: Variation in Pediatric Diabetic Ketoacidosis Care across Health Systems: A Multicountry Study

Introduction and Objective: To measure differences in pediatric diabetic ketoacidosis (DKA) care (ages 0-15 years) and outcomes between hospitals in four countries. Methods: This retrospective cohort study included all DKA episodes in people aged 0 to 15 years in the DEKODE (Digital Evaluation of Ketosis and Other Diabetes-related Emergencies) initiative from January 2020 to December 2023. Pseudonymized data on DKA diagnosis, resolution and length of stay was collected. An independent samples Kruskal-Wallis test was performed to assess differences in various parameters of DKA care and outcomes. Results: A total of 1641 DKA episodes from United States (n=1445), United Kingdom (n=46), India (n=25) and Uzbekistan (n=125) were analyzed. Centers from the US, India and Uzbekistan were represented by one regional hospital each. The UK data comprised 27 hospitals following the same guidelines. There were differences in precipitating cause and presentation, frequency of biochemical testing, electrolyte derangements, DKA duration, length of stay, and complications (Table 1). Conclusion: Significant variations in DKA outcomes between countries suggested differences in awareness, education and management possibly due to variation in guideline implementation. Future studies are needed to identify and share best practices. Disclosure P. Kempegowda: None. S. Hao: None. A. Manta: None. P. Vellanki: Consultant; Ended; Sanofi, RTI International.