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Research Article
Serological Prediction of infections in Diabetic
Patients with Diabetes Ketoacidosis in Penang, Malaysia
Syed
Wasif Gillani1*, Syed Azhar Syed Sulaiman1,
Shameni Sundram2, Yelly Oktavia Sari3,4,
Mirza Baig5 and Mian
Muhammad Shahid Iqbal6
1School of Pharmaceutical Sciences, Universiti Sains
Malaysia, Pulau Pinang, Malaysia, 2Doctor,
Hospital Pulau Pinang, 10990, Residential Street, Penang,
3Faculty of Pharmacy, Andalas University,
Padang 25163, Indonesia, 4Discipline of
Clinical Pharmacy, School of Pharmaceutical Sciences,
Universiti Sains Malaysia, 11800 Penang, 5Department
of Clinical Pharmacy, Aimst University, Kedah, 6School
of Pharmacy and Health Sciences, International Medical
University, Malaysia.
*For correspondence:
Email:
wasifgillani@gmail.com Tel:
+60174203027; Fax: +604-6570017
Received: 25
August
2011 Revised
accepted: 4 July 2012
Tropical
Journal of Pharmaceutical Research, October 2012;
11(5): 815-821
http://dx.doi.org/10.4314/tjpr.v11i5.16
Abstract
Purpose:
To
determine the prevalence and predictors of infection in
diabetic patients with diabetic ketoacidosis (DKA) who
were ≥18 years.
Methods:
A
retrospective cohort design was adopted for this study.
A total of 967 diabetes ketoacidosis patients from
Hospital Pulau Pinang for the 3-year period, Jan 2008 -
Dec 2010, were identified and enrolled. The data were
analysed, as appropriate, by Student t-test and ANOVA
for the normally distributed data, Mann-Whitney U rank
sum and Kruskall-Wallis tests for continuous,
non-nominal data and Chi-square for dichotomous
variables. Odd Ratios with 95% confidence interval (CI)
were also presented where applicable.
Results:
Of
the total diabetes ketoacidosis patients, 112 (11.6 %)
were cases without infection, 679 (70.2 %) bacterial
infection cases and 176 (18.2 %) presumed viral
infection cases. The mean white blood count (WBC) for
all the patients was 18,177 ± 9,431 while 721 (74.6 %)
had leukocytosis, defined by WBC ≥ 15,000/mm3.
WBC differential, leukocytosis, as well as sex and body
temperature were not significant predictors (p >.05) of
bacterial infection. There was, however, a significant
difference (p <.05) in terms of age within groups, as
those > 57 years showed a higher rate of infection.
Conclusion:
The infection rate in elderly patients with DKA is high
and a majority of them lack clinical evidence. Age has a
significant effect on the rate and prediction of
infection. Leukocytosis is commonly found but severe
ketoacidosis was more likely than the presence of
infection.
Keywords:
Diabetes mellitus, Diabetes ketoacidosis, Infections,
Predictors, White blood cells |
