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Risk factors for emergency hospital admission for diabetic ketoacidosis: national crosssectional analysis

RISK FACTORS FOR EMERGENCY HOSPITAL ADMISSION FOR DIABETIC KETOACIDOSIS: NATIONAL CROSSSECTIONAL ANALYSIS

Objectives: To determine key demographic and metabolic risk factors that increase the likelihood of hospital admission with diabetic ketoacidosis (DKA) in children and young people with Type 1 Diabetes in England and Wales.

RISK FACTORS FOR EMERGENCY HOSPITAL ADMISSION FOR DIABETIC KETOACIDOSIS: NATIONAL CROSSSECTIONAL ANALYSIS

Data Sources

- NPDA (2008-2010):

The National Paediatric Diabetes Audit (NPDA) reports highlight the main findings on the quality of care for infants, children and young people with diabetes in England and Wales (http://www.rcpch.ac.uk/national-paediatric-diabetes-audit-npda). Includes details on the number of infants, children and young people registered with paediatrics diabetes units in England and Wales and the care processes they receive

RISK FACTORS FOR EMERGENCY HOSPITAL ADMISSION FOR DIABETIC KETOACIDOSIS: NATIONAL CROSSSECTIONAL ANALYSIS

Data Sources

- Hospital Episode Statistics (2008-2010) - Patient Episode Database Wales (20082010)

HES and PEDW provide a comprehensive data source for all emergency hospital admissions.
They were used to identify patients that were hospitalised with DKA (ICD10 Code E101)

Country of residence Cholesterol Duration of diabetes

HbA1c

Deprivation

Covariates
Blood Pressure Ethnicity

BMI Age

Sex

RISK FACTORS FOR EMERGENCY HOSPITAL ADMISSION FOR DIABETIC KETOACIDOSIS: NATIONAL CROSS-SECTIONAL ANALYSIS

Statistical Analysis

Missing data was imputed Generalised Linear Multilevel Model


Dependent Variable: Number of hospital admissions for DKA Random effects: Paediatric diabetes units

Country of residence Cholesterol Duration of diabetes

HbA1c

Deprivation

Multilevel
model
Blood Pressure Ethnicity
Black

Sex BMI Age


Female

RISK FACTORS FOR EMERGENCY HOSPITAL ADMISSION FOR DIABETIC KETOACIDOSIS: NATIONAL CROSSSECTIONAL ANALYSIS

Results

Black ethnicity (IRR=1.2) (compared to white) Female sex (IRR=1.13) Poor diabetic control (HbA1c IRR = 1.08) Age (IRR=1.02) Diabetes duration (IRR=1.01) Deprivation (IMD score IRR=1.01)

RISK FACTORS FOR EMERGENCY HOSPITAL ADMISSION FOR DIABETIC KETOACIDOSIS: NATIONAL CROSSSECTIONAL ANALYSIS

Results

Black ethnicity (IRR=1.2) (compared to white) Female sex (IRR=1.13) Poor diabetic control (HbA1c IRR = 1.08) Age (IRR=1.02) Diabetes duration (IRR=1.01) Deprivation (IMD score IRR=1.01)

RISK FACTORS FOR EMERGENCY HOSPITAL ADMISSION FOR DIABETIC KETOACIDOSIS: NATIONAL CROSSSECTIONAL ANALYSIS

Further Work

Hypoglycaemia
Time Trends (2005-2011)