Diabetic ketoacidosis: outcome in a community hospital

The mortality among patients with diabetic ketoacidosis (DKA) has been reported to be as high as 5% to 15%. To determine the outcome of DKA, we reviewed the charts of all patients admitted to one of our community affiliated hospitals for the period of January 1979 to December 1981. We identified 66 episodes of DKA in 42 patients. All patients received intravenous fluids. Insulin was given by continuous infusion in six (9%), by bolus only in 14 (20%), and by a combination of the two in 46 (71%). The mean time for recovery from DKA was similar in all three subgroups. All patients recovered from DKA and were discharged from the hospital; no deaths occurred. We conclude that it is possible to treat DKA effectively in a community hospital, with mortality approaching zero.