Treatment Outcome and Associated Factors among Type 1 Diabetic Children<15 Years Admitted With DKA in Bahir Dar City Public Referral Hospital, North West, Ethiopia: A retrospective Cross Sectional Study

Abstract

Background: Length of hospital stay and overall in hospital mortality of diabetic keto acidosis during management are the foremost primary out comes that should be measured. Because, it is highly trusted on the improvement of diabetic keto acidosis related complication management. However, data associated to length of stay, mortality rate due to diabetic keto acidosis remains to be limited in Ethiopia.In addition to this, Nonfiction is much scarce in relation to factors associated with treatment outcome starting from its initial presentation and the overall management process. Objective: To assess treatment outcome of children<15 years old admitted with diabetic keto acidosis at Felege Hiwot comprehensive referral hospital, North West, Ethiopia, 2021Methods: Retrospective cross sectional study was conducted at Felege Hiwot comprehensive referral hospital among randomly selected sample of 176 children admitted with diabetic keto acidosis from 2016 to 2021.Data were collected by using data abstraction tool. Then it was coded, enter, cleaned and stored into Epi-data version 4.2 and was exported into STATA 14.0 statistical software for analysis. Categorical variables were described using proportions and compared using Chi-square test; whereas continuous parametric variables with mean and standard deviation and compared using parametric (t-test). Model goodness-of-fit and assumptions were checked. Finally, association between independent variables and length of hospital stay were assessed using binary logistics regression and Variables with p-value < 0.05 were considered as statistically significant.Result: The mean length of hospital stay was 9.5±6.2 days. About 59.3% of had long hospital stay (>7days).Majority of the clients (97.5%) were improve and discharged with 14.2% management complication and 4(2.5%) died in the hospital. Factors that affect long hospital stay were residence(AOR=4.31;95CI=1.25-14.80),family history of diabetes (AOR=0.12; 95%CI=0.02-0.64),glycaemia at admission (AOR=1.01;95%CI=1.00-1.02),insulin skipping (AOR=0.08;95%CI=0.01-0.98),abdominal pain(AOR=4.28;95%CI=1.11 -15.52), time in which the patient get out of diabetic keto acidosis(AOR=6.39;95%CI=1.09-37.50).Conclusion and Recommendation: Majority of clients were showed improvement and discharged to their home after longer hospital stay and with very low mortality rate followed by complication (14.2%).The time with in which the majority of the clients get out of DKA were found in between 24-48 hours. Thus, to achieve the intended treatment out come early in time, modification of the approach by emphasizing the above predictors is mandatory with the recommendation of multicenter study in this regard.