Evidence mapPaperPMID 42545873Full record

Observational studyCritical care explorations2026

Severity and Clinical Outcomes Among ICU Patients With Diabetic Ketoacidosis: An Analysis of the Japanese Intensive Care Patient Database.

Reina Miyazaki, Hiromu Okano, Shunsaku Goto, Haruna Tanaka, Hiroshi Okamoto

Abstract readObservational StudyMulticenter Study
In one paragraph

Observational study in Critical care explorations, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Reina MiyazakiDepartment of Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan.
Hiromu OkanoDepartment of Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan.ORCID 0000-0002-2116-0455
Shunsaku GotoDepartment of Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan.
Haruna TanakaDepartment of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Hiroshi OkamotoDepartment of Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

importanceDiabetic ketoacidosis (DKA) is an acute metabolic emergency characterized by hyperglycemia, ketosis, and acidosis due to insulin deficiency. While ICU admission is frequently considered for DKA, admission thresholds and resource utilization vary across countries and institutions. Current data linking admission severity to clinical outcomes among ICU-admitted patients with DKA remain limited.

objectivesTo describe clinical outcomes and ICU length of stay (LOS) stratified by arterial pH recorded during ICU day 1 among ICU-admitted patients with DKA in Japan. DESIGN, SETTING, AND

participantsRetrospective, multicenter observational study of adult patients admitted with a diagnosis of DKA to 95 ICUs across Japan between fiscal years 2015 and 2022. Patients were stratified by arterial pH recorded during ICU day 1 into severe (pH < 7.00), moderate (7.00 ≤ pH < 7.25), and mild (pH ≥ 7.25) groups. MAIN OUTCOMES AND MEASURES: The primary outcome was the in-hospital mortality rate. The secondary outcomes were ICU mortality, hospital LOS, and ICU LOS.

resultsAmong 866 eligible patients (mild, n = 449; moderate, n = 347; severe, n = 70), in-hospital mortality was low regardless of ICU day 1 pH severity (mild: 4.5%, moderate: 3.2%, and severe: 5.7%). ICU mortality was also low (mild: 1.6% [7/449], moderate: 1.4% [5/347], and severe: 2.9% [2/70]). Hospital LOS was similar across groups (mild: 17.0 d, interquartile range [IQR], 10.0-26.0 d; moderate: 15.0 d, IQR, 9.0-24.0 d; and severe: 15.0 d, IQR, 10.0-22.0 d), whereas ICU LOS tended to increase with severity (mild: 44.3 hr, IQR, 24.6-72.9 hr; moderate: 48.3 hr, IQR, 27.9-76.8 hr; and severe: 57.5 hr, IQR, 31.1-115.0 hr). CONCLUSIONS AND RELEVANCE: In this nationwide ICU registry, in-hospital mortality was low across arterial pH recorded during ICU day 1-defined severity strata, while ICU LOS tended to be longer in strata with more severe DKA. These findings are descriptive; clinically meaningful mortality differences cannot be excluded due to the small number of events, and further studies are needed to evaluate prognostic models and triage strategies.

Indexed as

Diabetic KetoacidosisHospital MortalityIntensive Care UnitsAdultAgedDatabases, FactualEast Asian PeopleFemaleHumansJapanLength of StayMaleMiddle AgedRetrospective StudiesSeverity of Illness Indexacidemiadiabetic ketoacidosisintensive care unitsJapanlength of stay

Identifiers

PMID42545873
PMCPMC13441131

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.