Comprehensive Assessment of the Characteristics of Pediatric Patients with Diabetic Ketoacidosis: 11 Years of Data from a Tertiary Center

Introduction: Our objective is to describe comprehensive patient characteristics and explore their relationships with the presence and severity of diabetic ketoacidosis (DKA) in pediatric patients with diabetes mellitus (DM). Materials and Methods:This retrospective, single-center study included pediatric patients with DM.Patients were categorized into those with and without DKA, and those with DKA were subclassified into mild, moderate, and severe groups.Clinical symptoms, biochemical parameters, and treatment needs, including intensive care unit (ICU) requirements, were evaluated.Data were obtained from electronic medical records, and analyses involved comparisons between patients with and without DKA and between DKA severity groups.Results: The study included 180 admissions of 150 patients, with 84 (46.7%) involving DKA.Compared to non-DKA subjects, patients with DKA had higher frequencies of abdominal pain (p=0.048),fatigue (p=0.011),vomiting (p<0.001),nausea (p=0.021),lethargy (p=0.046), and tachypnea (p=0.006), as well as higher prevalence of prior DKA (p<0.001),active infection (p=0.011),type 1 DM (p=0.015), and ICU admission (p=0.020).DKA patients had higher blood glucose (p<0.001),creatinine (p=0.009), and leukocyte counts (p<0.001), while sodium (p=0.045) and potassium (p=0.018) were lower.Patients with severe DKA had higher leukocyte count (p=0.001) compared to those with mild and moderate DKA, with a longer duration of ketoacidosis (p<0.001) and more frequent ICU admission (p=0.020).According to logistic regression analysis results, vomiting (p<0.001) and previous DKA history (p<0.001) were independent risk factors for DKA.For severe DKA, fatigue (p=0.031) was an independent risk factor.Conclusion: This study presents a comprehensive dataset concerning pediatric patients with DKA, and identifies multiple factors associated with DKA and its severity. ÖzGiriş: 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.