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J Korean Soc Emerg Med > Volume 20(1); 2009 > Article
Journal of The Korean Society of Emergency Medicine 2009;20(1): 86-94.
The Prognostic Factors For Alcoholic Ketoacidosis
Je Won Lee, Seung Jun Yang, Sang Chan Jin, Myeong Don Joo, Woo Ik Choi
Department of Emergency Medicine, School of Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea. emtaegu@dsmc.or.kr
This study was undertaken to evaluate the prognostic factors for patients suffering with alcoholic ketoacidosis.
We retrospectively evaluated and categorized 55 alcoholic ketoacidosis patients into two groups: the survivors (group 1) and non-survivors (group 2). We compared the general characteristics and the laboratory results, including the arterial blood gas analysis (ABGA) and the complications of the two groups, and we assessed the severity of the between the two groups by using the Acute Physiology and Chronic Health Evaluation (APACHE) II score and the Simplified Acute Physiology Score (SAPS).
There were 50 male patients (90%) and 5 female patients (10%). On laboratory testing, the levels of arterial HCO3-, total protein, albumin and serum glucose were significantly lower in group 2 than that in group 1. The levels of total bilirubin and BUN (blood urea nitrogen), the PT (prothrombin time) and the aPTT (activated partial thromboplastin time) were significantly higher in group 2 than that in group 1. Serial ABGA follow-up showed that unimproved ABGA results meant a poor prognosis. The SAPS was significantly higher for group 2 than that for group 1 (p<0.001) but the APACHE II was not significantly different. The incidence of hepatic encephalopathy, hepatic failure and acute respiratory distress syndrome (ARDS) were higher in group 2 than that in group 1. The total bilirubin, arterial HCO3- and albumin were found to be significant prognostic factors by logistic regression analysis.
The poor prognostic factors for alcoholic ketoacidosis were low levels of arterial HCO3-, impaired hepatic function, the incidence of ARDS and unimproved ABGA results.
Key words: Alcoholism, Ketosis, Prognosis
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