Recent trends in hospitalization for diabetic ketoacidosis in ontario children.
نویسندگان
چکیده
OBJECTIVE To investigate trends and geographic variation in diabetic ketoacidosis (DKA) hospitalization rates among children in Ontario from 1991 to 1999. RESEARCH DESIGN AND METHODS Canadian Institute for Health Information (CIHI) data were used to identify 15,872 diabetes-related hospital admissions in children younger than 19 years in Ontario from 1991 to 1999. Of these, 5,008 admissions were because of DKA and 10,864 admissions were because of conditions other than DKA (non-DKA). Small area variation analysis was used to compare areas with high versus low DKA admission rates. RESULTS There was a 19% relative decrease in the overall diabetes admission rate over the study period. Non-DKA admissions decreased by 29%, whereas DKA admissions remained stable. Total days of care decreased by 393 days per year for non-DKA admissions and by 99 days per year for DKA admissions. The average length of hospital stay decreased from 4.9 to 3.5 days for non-DKA admissions and from 4.5 to 3.2 days for DKA admissions. The fatality rate was 0.19% for non-DKA admissions and 0.18% for DKA admissions. Variation across geographic areas remained stable for DKA over the study period (Kendall's correlation coefficient 0.64, P = 0.017) with an average 3.7-fold difference between the lowest and highest regions. CONCLUSIONS Increased ambulatory care efforts for children with type 1 diabetes in Ontario have successfully reduced non-DKA admission rates. However, DKA admission rates have remained stable. Geographic variation for DKA admissions is low, but the observed 3.7-fold difference is clinically important for a preventable complication with a significant potential for long-term morbidity and mortality. Prevention strategies are needed, particularly in areas identified with the highest rates.
منابع مشابه
Causes of Hospitalization for Children with Diabetes and the Principles of Dietary Guidelines
From 23,231 total admission to three children's hospitals in Teheran over 3years and 6 months to 8 years period, 83 patients were found to have diabetes, 23 per thousand. The incidence of diabetes in children increases with age and is maximum in adolescence. In 83 diabetic children 59 were male and 24 female (F /M:(0.4.) From 83 diabetic patients 25 (31.2p.c.) were admitted with ketoacid...
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عنوان ژورنال:
- Diabetes care
دوره 25 9 شماره
صفحات -
تاریخ انتشار 2002