endocrine and metabolic disorders
Diabetic Ketoacidosis (DKA)
Prognosis for DKA
Overall mortality rates for diabetic ketoacidosis are < 1%; however, mortality is higher in older patients and in patients with other life-threatening illnesses. Shock or coma on admission indicates a worse prognosis. Main causes of death are circulatory collapse, hypokalemia, and infection. In older studies of children with clinically apparent cerebral edema, about one quarter of patients died, and 15 to 35% survived with persistent neurologic sequelae ( Prognosis references ). Another study had lower rates of persistent neurologic sequelae and death ( 1.Edge JA, Hawkins MM, Winter DL, Dunger DB: The risk and outcome of cerebral oedema developing during diabetic ketoacidosis.Arch Dis Child85(1):16-22, 2001. doi:10.1136/adc.85.1.16 2.Marcin JP, Glaser N, Barnett P, et al: Factors associated with adverse outcomes in children with diabetic ketoacidosis-related cerebral edema.J Pediatr141(6):793-797, 2002. doi:10.1067/mpd.2002.128888 3.Glaser N. Cerebral edema in children with diabetic ketoacidosis.Curr Diab Rep2001;1(1):41-46. doi:10.1007/s11892-001-0009-7 4.Kuppermann N, Ghetti S, Schunk JE, et al. Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis.N Engl J Med2018;378(24):2275-2287. doi:10.1056/NEJMoa1716816 