P-370: Epidemiological profile of pediatric patients with diabetic ketoacidosis admitted to a reference hospital in western São Paulo, Brazil
A Coelho, S SantelloAbstract
Introduction
Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes mellitus (T1DM), characterized by hyperglycemia, ketosis and metabolic acidosis. Its incidence and clinical profile in public referral centers in Brazil remain poorly documented.
Objectives
To assess DKA incidence trends over 10 years and describe the clinical and epidemiological profile of pediatric patients admitted to a tertiary public referral hospital in western São Paulo.
Methods
Retrospective descriptive study analyzing electronic medical records of patients aged 0–17 years admitted between January 2013 and December 2023 with ICD-10 codes E14 or E101 at Hospital Regional de Presidente Prudente. Data collected included age, sex, municipality of origin, length of stay, laboratory findings, and clinical complications. Ethics committee approval was obtained.
Results
Of 278 patients screened, 247 met inclusion criteria. DKA was confirmed in 180 patients (73%). Female patients predominated (58%). Mean age at admission was 12.1 years; mean hospital stay was 8 days. A total of 751 hospitalizations were recorded, averaging 4.17 admissions per patient. Hypovolemic shock occurred in 3 patients (1.6% of DKA cases); 6 patients (2.4%) required orotracheal intubation; vasoactive drugs were used in 2 cases (1.1%). Only 38% of patients resided in the hospital’s home city. DKA admissions peaked in 2016 (n=110) and showed a declining trend thereafter.
Conclusions
DKA predominantly affected female adolescents, consistent with literature. Severe complications were uncommon. A declining trend in admissions was observed after 2016, contrasting with studies reporting increased DKA rates during the COVID-19 pandemic. This regional epidemiological profile supports the need for early DM diagnosis strategies in public health systems.