The dawdle, dally and delay of diabetic ketoacidosis: Decoding the emergency department length of stay – A chart review

Journal of the Colleges of Medicine of South Africa

 
 
Field Value
 
Title The dawdle, dally and delay of diabetic ketoacidosis: Decoding the emergency department length of stay – A chart review
 
Creator Gangat, Raees Dufourq, Nicholas J. Havenga, Duncan M.
 
Subject Emergency Medicine diabetes; diabetic ketoacidosis; length of stay; emergency department; time to resolution
Description Background: Diabetic ketoacidosis is a life-threatening complication requiring prompt intervention. Understanding factors influencing the duration of emergency department (ED) stay is essential for optimising patient care and resource utilisation.Methods: A retrospective review was conducted on patients diagnosed with diabetic ketoacidosis at a regional hospital in KwaZulu-Natal between March 2022 and March 2023. Demographics, precipitants, severity, potassium levels and time to resolution were analysed to determine correlations between these variables and the duration of stay in the ED.Results: Of the 156 records, 105 met the inclusion criteria. The mean age was 36.8 years, with 51.4% male and 98.1% of black ethnicity. Poor compliance (37.1%) and infection (31.4%) were the commonest precipitants. Longer durations in the ED (16.2 h, p = 0.007) were linked to cases with unknown precipitants. The median stay was 6 h–12 h, with infection linked to the longest mean duration (10.1 h). Recurrent episodes occurred in 38.1% of patients. Severe diabetic ketoacidosis (13.0 hours, p = 0.001) and a lower pH at presentation (β = –19.6, p  0.001) were significantly associated with prolonged time to resolution. Potassium abnormalities (29.5%) had no significant effect on duration of stay (p = 0.775).Conclusion: Unknown precipitants significantly influenced the length of stay in the ED. Infection, severe acidosis, and hypokalaemia contributed with variable significance, highlighting that targeted interventions may potentially reduce congestion in these settings.Contribution: This study provides valuable insights into factors influencing ED length of stay for diabetic ketoacidosis patients, offering evidence to improve clinical management and resource allocation in regional hospitals.
 
Publisher AOSIS
 
Contributor Promise Gumbo, Research Consultant, Khumbula Consulting
Date 2025-06-13
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Retrospective Chart Review
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/jcmsa.v3i1.200
 
Source Journal of the Colleges of Medicine of South Africa; Vol 3, No 1 (2025); 8 pages 2960-110X 3105-4331
 
Language eng
 
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The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://jcmsa.org.za/index.php/jcmsa/article/view/200/580 https://jcmsa.org.za/index.php/jcmsa/article/view/200/581 https://jcmsa.org.za/index.php/jcmsa/article/view/200/582 https://jcmsa.org.za/index.php/jcmsa/article/view/200/583
 
Coverage Africa; South Africa; Kwazulu Natal; Pietermaritzburg 2022-2023: March 2022-March 2023 Age; Gender; Ethnicity
Rights Copyright (c) 2025 Raees Gangat, Nicholas J. Dufourq, Duncan M. Havenga https://creativecommons.org/licenses/by/4.0
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