Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Objectives: The aim of this study was to evaluate protocol adherence and its impact on inpatient mortality in patients with diabetic ketoacidosis (DKA) at a tertiary hospital in Karachi. The major hypothesis was that adherence to the DKA protocol reduces inpatient mortality.
Design: This was a retrospective cohort study.
Setting: The study was conducted at the Aga Khan University Hospital (AKUH), Karachi, a tertiary care hospital in Pakistan.
Participants: The study included patients diagnosed with DKA and admitted to AKUH from 2017 to 2021. Eligibility criteria included patients aged 18 and older, excluding those with incomplete records or referred to other hospitals.
Primary And Secondary Outcome Measures: The primary outcome was inpatient mortality. The analysis included Cox proportional hazards regression. Secondary outcome measures included predictors of mortality such as hypertension, intubation, tachycardia and elevated creatinine levels.
Results: Non-compliance with the DKA protocol (<70%) was associated with a significantly higher inpatient mortality rate (p=0.003). Survival analysis revealed a shorter median survival time for patients with <70% compliance (15 days versus 19 days, p<0.05). Multivariable analysis showed that non-compliance was an independent risk factor for adverse events (adjusted HR 1.37 (95% CI 1.01 to 1.86), p=0.04). Hypertension, intubation, tachycardia and elevated creatinine levels were significantly associated with increased mortality risk.
Conclusions: Adherence to the DKA protocol is crucial for reducing inpatient mortality and improving outcomes, especially in low- and middle-income countries. Ensuring at least 70% compliance is vital. Recommendations include continuous training for healthcare providers, adequate staffing and resource optimisation. Future research should focus on interventions to boost compliance and explore other factors affecting protocol adherence to further enhance patient care.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315034 | PMC |
| http://dx.doi.org/10.1136/bmjopen-2025-102173 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Immune Response Subphenotyping to Predict Mortality in Sepsis: A Prospective Study in Resource-Limited Setting.
Crit Care Explor
September 2025
Division of Tropical Medicine and Infectious Diseases, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Importance: Sepsis remains a leading cause of death in infectious cases. The heterogeneity of immune responses is a major challenge in the management and prognostication of patients with sepsis. Identifying distinct immune response subphenotypes using parsimonious classifiers may improve outcome prediction, particularly in resource-limited settings.
View Article and Find Full Text PDFAssociation of Atrial Ablation Procedure and Palliative Care for High-Risk Mortality Group With Atrial Fibrillation in U.S. Hospitals: 2016-2021 National Inpatient Sample Analysis.
J Palliat Care
September 2025
Department of Healthcare Administration and Policy, School of Public Health, University of Nevada, Las Vegas, NV, USA.
ObjectivesRecently, atrial fibrillation (AF) has contributed to an increase in cardiovascular deaths in the U.S. Palliative care (PC) and atrial ablation (AA) procedure can elevate quality of life of high-risk AF patients, who are associated with multiple comorbidities.
View Article and Find Full Text PDFDigiNet: Optimizing personalized care for patients with stage IV non-small cell lung cancer (NSCLC) through a digitally connected provider network-analysis plan of a prospective multicenter cohort trial.
J Cancer Res Clin Oncol
September 2025
Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany.
Purpose: The German sector-based healthcare system poses a major challenge to continuous patient monitoring and long-term follow-up, both essential for generating high-quality, longitudinal real-world data. The national Network for Genomic Medicine (nNGM) bridges the inpatient and outpatient care sectors to provide comprehensive molecular diagnostics and personalized treatment for non-small cell lung cancer (NSCLC) patients in Germany. Building on the established nNGM infrastructure, the DigiNet study aims to evaluate the impact of digitally integrated, personalized care on overall survival (OS) and the optimization of treatment pathways, compared to routine care.
View Article and Find Full Text PDFImaging surveillance for thoracic aortic aneurysms in Medicare beneficiaries.
JTCVS Open
August 2025
Department of Cardiac Surgery, University of Michigan Medical School, Ann Arbor, Mich.
Background: Regular imaging surveillance is guideline-recommended for the management of thoracic aortic aneurysm (TAA) but has not been well described in clinical practice. Here we evaluated the frequency of imaging procedures and associated outcomes, procedures, and healthcare costs in patients with TAA.
Methods: A retrospective cohort study of inpatient and professional claims for 28,459 Medicare beneficiaries age ≥65 years with a diagnosis of TAA between 2017 and 2019 was performed.
Prolonged Mechanical Ventilation Before Venovenous Extracorporeal Membrane Oxygenation and In-Hospital Mortality in Patients With Acute Respiratory Distress Syndrome.
Crit Care Med
July 2025
Division of Critical Care, Department of Medicine, The Queen's Medical Center, Honolulu, HI.
Objectives: To evaluate the relationship between the duration of pre-extracorporeal membrane oxygenation (ECMO) mechanical ventilation and mortality in acute respiratory distress syndrome (ARDS) patients undergoing venovenous ECMO.
Design: Retrospective cross-sectional study using the National Inpatient Sample database.
Setting: National Inpatient Sample database from January 2019 to December 2022.