Prevalence of Hypokalemia and Associated Factors Among Diabetic Keto-Acidosis Patients Visiting Emergency Department of Saint Paul’s Hospital Millennium Medical College and Addis Ababa Burn, Emergency and Trauma Hospital: Cross Sectional Study

Abstract

Abstract Background: Diabetes ketoacidosis (DKA) is one of the most serious acute complications of diabetes. Although diabetic ketoacidosis (DKA) patients are expected to have low total body potassium levels, measured levels may be low, normal, or elevated due to extracellular potassium shifts caused by acidosis or other factors. Objective: The purpose of this study is to determine the prevalence of hypokalemia and its associated factors in diabetic ketoacidosis patients admitted to the Emergency Department at St. Paul's Hospital Millennium Medical College (SPHMMC) and AaBET Hospital in Addis Ababa, Ethiopia, from September 2020to August 2023. Methods: A facility-based cross-sectional study was conducted. A systematic random sampling technique was used to select 317 patients. Data were collected by electronic capture technique using an open data kit (ODK). SPSS version 20 was used for the analysis. Bivariate analysis was performed at a p-value < 0.25 of significance level to select candidate variables for multivariable analysis, and then in the final model, factors with p-value < 0.05 were declared as significantly associated with hypokalemia in DKA patients. Results: There were 317 charts reviewed in total, with 150 (47.3%) males and 167 (52.27%) females. The patient's average age was 36.18±14.91 years. The mean potassium concentration was 4.12 (SD±0.682 mEq/L). Thirty-one (9.8%) of the 317 study participants had hypokalemia (k+ < 3.5 mEq/l) at presentation. Among the 84 patients with repeated serum potassium levels, The mean level of repeated was 3.91 (SD±0.688 mEq/l). During treatment, 23 [7.3%] of the 83 patients with repeated potassium levels developed hypokalemia. Triage score, duration of diabetes, diarrhea, depressed mental status, severity of DKA, and insulin therapy all showed a significant association with hypokalemia after bivariable and multivariable logistic regression analyses. Conclusion: In this study, hypokalemia was observed in 9.8% of patients with DKA at presentation and 7.3% during DKA treatment. More research is needed to better understand the risks and benefits of administering insulin and other associated factors before obtaining serum potassium levels. Keywords: diabetic ketoacidosis, hypokalemia, Ethiopia