ORIGINAL ARTICLES   

Minerva Endocrinologica 2011 December;36(4):267-72

Copyright © 2012 EDIZIONI MINERVA MEDICA

language: English

Determinants of altered sensorium at presentation with diabetic ketoacidosis

Ekpebegh C., Longo-Mbenza B. ✉

Department of Internal Medicine, Faculty of Health Sciences, Walter Sisulu University, Mthatha, Eastern Cape Province, South Africa

AIM: The aim of this paper was to determine the prevalence of altered sensorium and their determinants in diabetic ketoacidosis (DKA).
METHODS:Retrospective review of medical records for diabetic ketoacidosis admissions over a two year period.
RESULTS:A total of 94 admissions for DKA in 89 patients were reviewed. Majority of admissions were female related. The mean age of the subjects was 39.1±18.5 years. The prevalence of altered sensorium defined as Glasgow coma scale (GCS) below 15 was 47.9%. In Model 1, systolic blood pressure (SBP) <90 mmHg (odds ratio [OR] 17.5 95% Confidence Interval (CI) 2.1-142.9; P=0.008 and calculated effective serum osmolality >320 mosmol/Kg (OR 3.6 95% CI 1.4-12.2; P=0.043 were independently associated with altered sensorium. In Model 2 where serum osmolality was substituted with uncorrected serum sodium, SBP <90 mmHg OR 19.6 95% CI 2.2–100; P=0.007, uncorrected serum sodium >150 mmol/L OR 18.5 95% CI 2.1-100; P=0.0009 and white cell count >25 x 106/L OR 3.6 95% CI 1.03-13.5; P=0.05 were independently associated with altered sensorium.
CONCLUSION: Systolic blood pressure <90 mmHg, calculated effective serum osmolality >320 mosmol/Kg, uncorrected serum sodium >150 mmol/L and white bood count >25 x 106/L were independently associated with altered sensorium.