A cross-sectional analysis of patient-based records on mortality among patients with diabetic ketoacidosis in a tertiary hospital in Ghana

Objectives: To determine the mortality of patients admitted and managed for Diabetic ketoacidosis (DKA) at a teaching hospital Design: A cross-sectional study of the medical records of all 70 patients 18 years and older, managed for DKA in the adult emergency room of Korle-Bu Teaching Hospital in Ghana from March to July 2019. Setting: The study was conducted among adult patients managed for diabetic ketoacidosis in the adult emergency room and adult medical wards of Korle-Bu Teaching Hospital. Participants: The participants were patients aged 18 years or older who were admitted with diabetic ketoacidosis. Interventions: Patients managed for diabetic ketoacidosis in the adult emergency room of Korle-Bu Teaching Hospital in Ghana had their outcomes assessed. Main outcome measures: Outcomes of DKA management, including mortality, discharge, duration to either of these outcomes and associations were measured. Results: The mortality rate from DKA in this study was 15.7%. Mean age, duration of diabetes, and blood glucose at admission were 44.06(±16.23) years, 7.19(±6.04) years, and 26.37(±6.70) mmol/L, respectively. Female gender and pulse rate >100 or <60 beats/minute were independently associated with mortality. Only 2 out of 70 (2.85%) patients were managed in the Intensive Care Unit (ICU). Conclusion: The Mortality of DKA management in this hospital was high (15.7%). Most of these patients (97.15%) were not managed in the ICU or HDU; to improve this high mortality, there is a need to use the guidelines in the diagnosis, categorisation and management of DKA and to make the ICU and HDU available, accessible and affordable in our centre and elsewhere in Ghana.