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Predictors of Suwarto et al for 5-Day Mortality in a Patient with Diabetic Ketoacidosis

Description

Suwarto et al identified predictors of 5-day mortality following emergency admission for a patient with diabetic ketoacidosis. These can help to identify a patient who may benefit from more aggressive management. The authors are from Cipto Mangunkusumo Hospital in Jakarta and Public Health Universitas Indonesia.


Patient selection: adult with emergency admission for diabetic ketoacidosis

 

Outcome: death within 5 days of presentation

 

Parameters (presumably on admission):

(1) serum lactate in mmol/L

(2) sensorium

 

Parameter

Finding

Points

serum lactate

< 4 mmol/L

0

 

>= 4 mmol/L

1

sensorium

normal

0

 

altered, stupor, coma

1

 

number of poor prognostic findings =

= SUM(points for both parameters)

 

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 2

• The risk of mortality increases with the number of risk factors.

• Altered sensorium may be a marker of sepsis or serious infection. Patients who were septic had a worse survival than those who were not septic.

 


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