| Abstract | Cilj istraživanja: Prikazati klinička obilježja i laboratorijske parametre pri prijemu te moguće komplikacije bolesti u bolesnika koji su pod dijagnozom dijabetičke ketoacidoze zahtijevala intenzivno liječenje.Materijali i metode: U istraživanje su uključeni punoljetni ispitanici koji su zbog dijabetičke ketoacidoze liječeni na Intenzivnom odjelu Interne klinike KBC-a Split u razdoblju od 1.siječnja 2013. do 31. prosinca 2018. godine. Retrospektivno je analizirana medicinska dokumentacija. U radu se koriste metode grafičkog i tabelarnog prikazivanja kojima se prezentira struktura promatranih varijabli u odabranom šestogodišnjem razdoblju.
Rezultati: U istraživanje su uključena 82 bolesnika,33 bolesnika su žene (40,24%), dok je muškaraca 49 (59,76%). Prosječna dob je bila 43 godine. Najčešći ishod liječenja je preživljenje, 81 put učestalije u odnosu na smrtni ishod, te je zastupljenost preživljavanja prevladavajuća (p<0,001). Srednja vrijednost duljine hospitalizacije je za muškarce 9,71 dan, dok je za žene 8,94 dana (IQR= 6-12). Bolesnici su struktuirani prema tipu šećerne bolesti. 76,83 % bolesnika (63/82) ima dijagnozu šećerne bolesti tip 1, dok tip 2 ima 23,17% (19/82). Većina bolesnika, čak 90,24% (74/82) pri prijemu je već bila s dugogodišnjom anamnezom šećerne bolesti. 9,76 % (8/82) je novo dijagnosticiranih bolesnika. 7 od njih (87,5%) ima šećernu bolest tip 1, dok 1 bolesnik (12,5%) ima dijagnosticiran tip 2 bolesti. Bolesnike smo razvrstali i prema težini dijabetičke ketoacidoze na laku, umjerenu i tešku. Prema stupnju DKA najčešći stupanj je umjereni,te je 2,76 puta učestalije zastupljen u odnosu na laki stupanj, te 2,61 put u odnosu na teški stupanj DKA.
Zaključak:Udio bolesnika sa šećernom bolesti tip 1 je 76,83% , što znači da se DKA češće pojavljuje u tih bolesnika. Većina promatranih bolesnika kao simptom DKA-e imala je povraćanje, čak 70,73 %. Ostalih 29,27 % imalo je podjednako mučninu, poremećaj svijesti i bol u trbuhu. Kao najčešći uzrok DKA-e pokazane su infekcije, te su 6,75 puta učestalije zastupljene među promatranim bolesnicima u odnosu na novootkriveni DM koji je prisutan kod 4,88% promatranih bolesnika. Važno je i kontinuirano provođenje javnozdravstvenih programa s ciljem edukacije stanovništva kako bi rano prepoznali simptome i znakove šećerne bolesti i njenih akutnih, po život opasnih komplikacija. |
| Abstract (english) | OBJECTIVES: To present clinical characteristics, laboratory parameters and possible complications of patients with diabetic ketoacidosis (DKA) requiring intensive care treatment at the time of admission.
MATERIAL AND METHODS: The study included adult subjects who were treated for DKA in the Intensive Care Unit of the Internal Medicine Clinic of the University Hospital Split during the period from January 1st 2013. until December 31st 2018. Medical records were retrospectively analyzed. In thesis, methods of graphical and tabular presentation that present the structure of the observed variables in the selected six-year period, are being used.
RESULTS: The study included 82 patients, 33 patients were women (40.24%), while men were 49 (59.76%). The mean age was 43 years. The most common treatment outcome was survival, 81 times more common than death, and the prevalence of survival was predominant (p <0.001). The mean length of hospital stay was 9.71 days for men and 8.94 days for women (IQR = 6-12). Patients were structured according to the type of diabetes. 76.83% of patients (63/82) have a diagnosis of type 1 diabetes, while type 2 has 23.17% (19/82). Most patients, as many as 90.24% (74/82) were already with a long history of diabetes. 9.76% (8/82) are newly diagnosed patients. 7 of them (87.5%) have type 1 diabetes, while 1 patient (12.5%) has been diagnosed with type 2 disease. We also classified patients according to the severity of diabetic ketoacidosis into mild, moderate and severe. According to the degree of DKA, the most common degree is moderate, and is 2.76 times more common than mild, and 2.61 times more severe than DKA.
CONCLUSION: The proportion of patients with type 1 diabetes is 76.83%, which means that DKA occurs more often in these patients. The majority of patients observed as a symptom of DKA had vomiting, as many as 70.73%. The other 29.27% had equally nausea, impaired consciousness, and abdominal pain. Infections have been shown to be the most common cause of DKA, and are 6.75 times more common among the observed patients compared to the newly detected DM, which is present in 4.88% of the observed patients. It is also important to continuously implement public health programs with the aim of educating the population in order to early recognize the symptoms and signs of diabetes and its acute, life-threatening complications. |
