Diabetic ketoacidosis tied to poor survival in seniors

Diabetic ketoacidosis (DKA) is common in older adults and appears to worsen outcomes, a recent study has found.

Researchers conducted a retrospective matched cohort study of 385 consecutive patients diagnosed with DKA and hospitalized between 2004 and 2007. The primary outcome was in-hospital mortality; secondary outcomes were 30-day and 1-year mortality, along with the duration of hospitalization and recurrent DKA.

Patients were categorized according to age: 307 (79.7 percent) were younger than 65 years, while the remaining 78 (20.3 percent) were older. Both age subgroups had similar laboratory profiles except for the higher concentration of serum glucose in the older patients (639±227.62 vs 539±215.14 mg/dL; p<0.0001).

Five and 13 patients in the younger and older subgroups died while admitted, resulting in statistically different in-hospital mortality rates (1.6 percent vs 16.7 percent; p<0.0001). Thirty-day mortality was likewise significantly greater in the older group (12.8 percent vs 0.7 percent; p<0.0001), as was 1-year mortality (23.1 percent vs 4.6 percent; p<0.0001).

Durations of admission to the hospital (5 vs 3 days) and to the intensive care unit (4 vs 3 days) were also significantly longer in the older subgroups.

In contrast, at 1 year after the index DKA episode, the younger subgroup made more visits to the diabetes mellitus clinic than their older counterparts (median, 1 vs 0; p<0.0001).

No significant between-group differences were reported for admission rate to intensive care and DKA recurrence at any time point.