Population-based study of incidence and risk factors for cerebral edema in pediatric diabetic ketoacidosis
To determine incidence, outcomes, and risk factors for pediatric cerebral edema with diabetic ketoacidosis (CEDKA) in Canada. This was a case-control study nested within a population-based active surveillance study of CEDKA in Canada from July 1999 to June 2001. Cases are patients with DKA
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| Veröffentlicht in: | The Journal of pediatrics 2005-05, Vol.146 (5), p.688-692 |
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| container_title | The Journal of pediatrics |
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| creator | Lawrence, Sarah E. Cummings, Elizabeth A. Gaboury, Isabelle Daneman, Denis |
| description | To determine incidence, outcomes, and risk factors for pediatric cerebral edema with diabetic ketoacidosis (CEDKA) in Canada.
This was a case-control study nested within a population-based active surveillance study of CEDKA in Canada from July 1999 to June 2001. Cases are patients with DKA |
| doi_str_mv | 10.1016/j.jpeds.2004.12.041 |
| format | Article |
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This was a case-control study nested within a population-based active surveillance study of CEDKA in Canada from July 1999 to June 2001. Cases are patients with DKA <16 years of age with cerebral edema. Two unmatched control subjects per case are patients with DKA without cerebral edema.
Thirteen cases of CEDKA were identified over the surveillance period for an incidence rate of 0.51%; 23% died and 15% survived with neurologic sequelae. CEDKA was present at initial presentation of DKA in 19% of cases. CEDKA was associated with lower initial bicarbonate (
P
=
.001), higher initial urea (
P
=
.001), and higher glucose at presentation (
P
=
.014). Although there was a trend to association with higher fluid rates and treatment with bicarbonate, these were not independent predictors.
CEDKA remains a significant problem with a high mortality rate. No association was found between the occurrence of CEDKA and treatment factors. The presence of cerebral edema before treatment of DKA and the association with severity of illness suggest that prevention of DKA is the key to avoiding this devastating complication.</description><identifier>ISSN: 0022-3476</identifier><identifier>EISSN: 1097-6833</identifier><identifier>DOI: 10.1016/j.jpeds.2004.12.041</identifier><identifier>PMID: 15870676</identifier><identifier>CODEN: JOPDAB</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Adolescent ; Biological and medical sciences ; Brain Edema - etiology ; Brain Edema - therapy ; Canada - epidemiology ; Case-Control Studies ; Child ; Child, Preschool ; Diabetes. Impaired glucose tolerance ; Diabetic Ketoacidosis - complications ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Female ; General aspects ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Humans ; Incidence ; Infant ; Male ; Medical sciences ; Nervous system (semeiology, syndromes) ; Neurology ; Population Surveillance - methods ; Risk Factors</subject><ispartof>The Journal of pediatrics, 2005-05, Vol.146 (5), p.688-692</ispartof><rights>2005 Elsevier Inc.</rights><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c387t-532d21a4657aa061532ee1b4e2cb38dcd2f4e22c486853cd48cd56b4dac24b763</citedby><cites>FETCH-LOGICAL-c387t-532d21a4657aa061532ee1b4e2cb38dcd2f4e22c486853cd48cd56b4dac24b763</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jpeds.2004.12.041$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16802618$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15870676$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lawrence, Sarah E.</creatorcontrib><creatorcontrib>Cummings, Elizabeth A.</creatorcontrib><creatorcontrib>Gaboury, Isabelle</creatorcontrib><creatorcontrib>Daneman, Denis</creatorcontrib><title>Population-based study of incidence and risk factors for cerebral edema in pediatric diabetic ketoacidosis</title><title>The Journal of pediatrics</title><addtitle>J Pediatr</addtitle><description>To determine incidence, outcomes, and risk factors for pediatric cerebral edema with diabetic ketoacidosis (CEDKA) in Canada.
This was a case-control study nested within a population-based active surveillance study of CEDKA in Canada from July 1999 to June 2001. Cases are patients with DKA <16 years of age with cerebral edema. Two unmatched control subjects per case are patients with DKA without cerebral edema.
Thirteen cases of CEDKA were identified over the surveillance period for an incidence rate of 0.51%; 23% died and 15% survived with neurologic sequelae. CEDKA was present at initial presentation of DKA in 19% of cases. CEDKA was associated with lower initial bicarbonate (
P
=
.001), higher initial urea (
P
=
.001), and higher glucose at presentation (
P
=
.014). Although there was a trend to association with higher fluid rates and treatment with bicarbonate, these were not independent predictors.
CEDKA remains a significant problem with a high mortality rate. No association was found between the occurrence of CEDKA and treatment factors. The presence of cerebral edema before treatment of DKA and the association with severity of illness suggest that prevention of DKA is the key to avoiding this devastating complication.</description><subject>Adolescent</subject><subject>Biological and medical sciences</subject><subject>Brain Edema - etiology</subject><subject>Brain Edema - therapy</subject><subject>Canada - epidemiology</subject><subject>Case-Control Studies</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diabetic Ketoacidosis - complications</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Female</subject><subject>General aspects</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Population Surveillance - methods</subject><subject>Risk Factors</subject><issn>0022-3476</issn><issn>1097-6833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE2LFDEQhoMo7rj6CwTJRW_d5quTzMGDLOouLOhBzyGdVEN6ezpjKi3svzfjDOzNU1XB874UDyFvOes54_rj3M9HiNgLxlTPRc8Uf0Z2nO1Np62Uz8mOMSE6qYy-Iq8QZ8bYXjH2klzxwRqmjd6R-Uc-bouvKa_d6BEixbrFR5onmtaQIqwBqF8jLQkf6ORDzQXplAsNUGAsfqEQ4eAbTds3ydeSAm1zhNqWB6jZt5qMCV-TF5NfEN5c5jX59fXLz5vb7v77t7ubz_ddkNbUbpAiCu6VHoz3TPN2A_BRgQijtDFEMbVdBGW1HWSIyoY46FFFH4QajZbX5MO591jy7w2wukPCAMviV8gbOm3MXli5b6A8g6FkxAKTO5Z08OXRceZOit3s_il2J8WOC9cUt9S7S_02HiA-ZS5OG_D-AngMfpmKbyLxidOWCc1t4z6dOWgy_iQoDkM6-Y6pQKgu5vTfR_4CfnmcUQ</recordid><startdate>20050501</startdate><enddate>20050501</enddate><creator>Lawrence, Sarah E.</creator><creator>Cummings, Elizabeth A.</creator><creator>Gaboury, Isabelle</creator><creator>Daneman, Denis</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20050501</creationdate><title>Population-based study of incidence and risk factors for cerebral edema in pediatric diabetic ketoacidosis</title><author>Lawrence, Sarah E. ; Cummings, Elizabeth A. ; Gaboury, Isabelle ; Daneman, Denis</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c387t-532d21a4657aa061532ee1b4e2cb38dcd2f4e22c486853cd48cd56b4dac24b763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adolescent</topic><topic>Biological and medical sciences</topic><topic>Brain Edema - etiology</topic><topic>Brain Edema - therapy</topic><topic>Canada - epidemiology</topic><topic>Case-Control Studies</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Diabetic Ketoacidosis - complications</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Female</topic><topic>General aspects</topic><topic>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Population Surveillance - methods</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lawrence, Sarah E.</creatorcontrib><creatorcontrib>Cummings, Elizabeth A.</creatorcontrib><creatorcontrib>Gaboury, Isabelle</creatorcontrib><creatorcontrib>Daneman, Denis</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lawrence, Sarah E.</au><au>Cummings, Elizabeth A.</au><au>Gaboury, Isabelle</au><au>Daneman, Denis</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Population-based study of incidence and risk factors for cerebral edema in pediatric diabetic ketoacidosis</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>2005-05-01</date><risdate>2005</risdate><volume>146</volume><issue>5</issue><spage>688</spage><epage>692</epage><pages>688-692</pages><issn>0022-3476</issn><eissn>1097-6833</eissn><coden>JOPDAB</coden><abstract>To determine incidence, outcomes, and risk factors for pediatric cerebral edema with diabetic ketoacidosis (CEDKA) in Canada.
This was a case-control study nested within a population-based active surveillance study of CEDKA in Canada from July 1999 to June 2001. Cases are patients with DKA <16 years of age with cerebral edema. Two unmatched control subjects per case are patients with DKA without cerebral edema.
Thirteen cases of CEDKA were identified over the surveillance period for an incidence rate of 0.51%; 23% died and 15% survived with neurologic sequelae. CEDKA was present at initial presentation of DKA in 19% of cases. CEDKA was associated with lower initial bicarbonate (
P
=
.001), higher initial urea (
P
=
.001), and higher glucose at presentation (
P
=
.014). Although there was a trend to association with higher fluid rates and treatment with bicarbonate, these were not independent predictors.
CEDKA remains a significant problem with a high mortality rate. No association was found between the occurrence of CEDKA and treatment factors. The presence of cerebral edema before treatment of DKA and the association with severity of illness suggest that prevention of DKA is the key to avoiding this devastating complication.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>15870676</pmid><doi>10.1016/j.jpeds.2004.12.041</doi><tpages>5</tpages></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Adolescent Biological and medical sciences Brain Edema - etiology Brain Edema - therapy Canada - epidemiology Case-Control Studies Child Child, Preschool Diabetes. Impaired glucose tolerance Diabetic Ketoacidosis - complications Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Female General aspects Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Humans Incidence Infant Male Medical sciences Nervous system (semeiology, syndromes) Neurology Population Surveillance - methods Risk Factors |
| title | Population-based study of incidence and risk factors for cerebral edema in pediatric diabetic ketoacidosis |
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