Efstathiou et al identified predictors for mortality in a patient with diabetic ketoacidosis (DKA). This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Athens and Sotiria General Hospital.
Patient selection: diabetic ketoacidosis
Parameter:
(1) severe co-existing disease at presentation
(2) pH at presentation
(3) regular insulin dose in IU during first 12 hours
(4) serum glucose in mmol/L after 12 hours
(5) mental status after 24 hours
(6) fever after 24 hours
Parameter |
Finding |
Points 1 |
Points 2 |
co-existing disease |
absent |
0 |
0 |
|
present |
1 |
6 |
pH |
>= 7.0 |
0 |
0 |
|
< 7.0 |
1 |
4 |
regular insulin |
<= 50 IU |
0 |
0 |
|
> 50 IU |
1 |
4 |
serum glucose |
<= 16.7 mmol/L |
0 |
0 |
|
> 16.7 mmol/L |
1 |
4 |
mental status |
normal |
0 |
0 |
|
depressed |
1 |
4 |
fever |
absent |
0 |
0 |
|
present |
1 |
3 |
total tally score =
= SUM(points 1 for all 6 parameters)
total points score =
= SUM(points 2 for all 6 parameters)
Interpretation:
• minimum scores: 0
• maximum tally score: 6
• maximum points score: 25
• The higher the score the greater the mortality.
Tally Score |
Mortality |
0 to 2 |
0% |
3 |
2% |
4 |
21% |
5 |
88% |
6 |
100% |
Total Points Score |
Mortality |
0 to 14 |
1% |
15 to 18 |
21% |
19 to 25 |
93% |
Specialty: Endocrinology, Clinical Laboratory