Journal Article

Infection as a Trigger of Diabetic Ketoacidosis in Intensive Care—Unit Patients

Elie Azoulay, Sylvie Chevret, Judith Didier, Ségolène Neuville, Michel Barboteu, Caroline Bornstain, Michaël Darmon, Jean-Roger Le Gall, Patrick Vexiau and Benoît Schlemmer

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 32, issue 1, pages 30-35
Published in print January 2001 | ISSN: 1058-4838
Published online January 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/317554
Infection as a Trigger of Diabetic Ketoacidosis in Intensive Care—Unit Patients

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We determined the prevalence and indicators of infection in intensive care unit (ICU) patients with diabetic ketoacidosis (DKA) by performing a retrospective analysis of 123 episodes of DKA (in 113 patients) managed in a medical ICU between 1990 and 1997. In univariate analysis, features associated with infection were female sex, neurological symptoms at admission, fever during the week before admission, a need for colloids, a high blood lactate level at admission, and lack of complete clearance of ketonuria within 12 h. Multivariate analysis identified 3 independent predictors of infection: female sex (odds ratio [OR], 2.31; confidence interval [CI], 1.05–5.35), neurological symptoms at admission (OR, 2.83; CI, 1.18–6.8), and lack of complete clearance of ketonuria within 12 h (OR, 3.73; CI, 1.58–9.09). Infection is the leading trigger of DKA in ICU patients. Neurological symptoms at admission and lack of complete clearance of ketonuria within 12 h are useful warning signals of infection.

Journal Article.  3421 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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