Table 1.
Prevalence and rate of diabetic ketoacidosis (DKA) by patient and hospital characteristics in the US pediatric population
| N (%), DKA admissions | Rate per 10 000 admissions (95% CI) | P value | Rate per 10 000 youth with diabetes (95% CI) | |
|---|---|---|---|---|
| Total | 149 535 (100) | 151.0 (147.1-155.0) | 1547.3 (1434.7-1660.0) | |
| Admissions by type | ||||
| Type 1 diabetes | 142 112 (95.0) | -- | -- | |
| Type 2 diabetes | 7422 (5.0) | -- | -- | |
| Age, y | <0.0001 | |||
| 0-2 | 4036 (2.7) | 10.9 (10.2-11.6) | 4859.5 (2424.8-7294.2) | |
| 3-5 | 4914 (3.3) | 55.7 (52.7-58.9) | 1497.4 (1110.2-1884.6) | |
| 6-8 | 9856 (6.6) | 120.1 (114.3-126.2) | 1426.3 (1109.4-1743.3) | |
| 9-11 | 15 760 (10.5) | 243.7 (233.2-254.7) | 1966.2 (1241.7-2690.7 | |
| 12-14 | 28 200 (18.9) | 285.5 (273.5-298.1) | 1600.9 (1326.6-1875.3) | |
| 15-17 | 30 356 (20.3) | 230.5 (221.7-239.7) | 1373.1 (1157.1-1589.1) | |
| 18-20 | 55 788 (37.3) | 371.4 (363.1-379.8) | 1472.8 (1270.5-1675.1) | |
| Unknown | 624 (0.4) | 129.5 (111.2-150.8) | -- | |
| Sex | <0.0001 | |||
| Male | 68 325 (45.7) | 129.2 (125.6-133.1) | 1423.6 (1256.7-1590.6) | |
| Female | 80 335 (53.7) | 176.9 (172.3-181.6) | 1651.4 (1451.2-1851.7) | |
| Unknown | 875 (0.6) | 118.5 (99.7-140.7) | -- | |
| Race/ethnicity | <0.0001 | |||
| White | 74 041 (49.5) | 170.1 (165.2-175.2) | 1269.0 (1136.0-1401.9) | |
| Black | 27 616 (18.5) | 188.1 (180.9-195.5) | 1815.8 (1448.1-2183.5) | |
| Hispanic | 18 415 (12.3) | 102.6 (97.7-107.8) | 1120.6 (926.7-1314.5) | |
| Asian or Pacific Islander | 1554 (1.0) | 67.7 (60.3-74.6) | 789.3 (140.8-1437.7) | |
| Native American | 1052 (0.7) | 134.0 (117.8-152.5) | 659.3 (504.8-813.8) | |
| Other | 4924 (3.3) | 108.3 (101.7-115.3) | 1595.1 (1064.1-2126.0) | |
| Unknown | 21 932 (14.7) | 144.1 (134.8-153.9) | -- | |
| Payer | <0.0001 | |||
| Private | 63 240 (42.3) | 148.8 (144.2-153.6) | 1345.9 (1188.6-1503.2) | |
| Public | 65 768 (44.0) | 139.6 (135.3-144.1) | 1773.5 (1561.1-1985.9) | |
| Self-pay or no charge | 11 825 (7.9) | 248.5 (237.8-259.5) | 1532.7 (1240.2-1825.1) | |
| Other | 8438 (5.6) | 188.2 (175.7-201.5) | 1984.5 (1551.7-2417.3) | |
| Unknown | 264 (0.2) | 142.9 (104.9-194.5) | -- | |
| Urbanicity | <0.0001 | |||
| Nonurban | 27 919 (18.7) | 174.0 (168.2-180.0) | -- | |
| Urban | 120 757 (80.8) | 147.4 (143.3-151.6) | -- | |
| Unknown | 859 (0.6) | 82.4 (70.9-95.8) | -- | |
| Household income | <0.0001 | |||
| Quartile 1 (lowest) | 48 095 (32.2) | 156.7 (151.6-162.0) | 1520.7 (1307.8-1733.6) | |
| Quartile 2 | 38 943 (26.0) | 162.1 (157.5-166.9) | 1506.9 (1278.5-1735.2) | |
| Quartile 3 | 34 095 (22.8) | 152.9 (148.0-158.0) | 1562.1 (1234.5-1889.7) | |
| Quartile 4 (highest) | 25 614 (17.1) | 129.5 (123.8-135.5) | 1476.9 (1280.4-1673.3) | |
| Unknown | 2788 (1.9) | 124.3 (114.5-134.9) | -- | |
| Hospital region | <0.0001 | |||
| Northeast | 21 079 (14.1) | 114.5 (107.2-122.5) | 1449.6 (1181.2-1718.1) | |
| Midwest | 36 374 (24.3) | 163.4 (155.0-172.3) | 1607.7 (1394.2-1821.3) | |
| South | 59 829 (40.0) | 161.2 (154.8-167.9) | 1561.0 (1371.2-1750.8) | |
| West | 32 253 (21.6) | 151.8 (142.9-161.2) | 1525.2 (1229.2-1821.2) | |
| Hospital ownership | <0.0001 | |||
| Government | 16 851 (11.3) | 163.8 (154.0-174.2) | -- | |
| Private | 106 561 (71.3) | 160.0 (155.4-164.6) | -- | |
| Unknown | 26 123 (17.5) | 118.1 (112.1-124.5) | -- | |
| Hospital size by bed number | 0.0331 | |||
| Small | 18 846 (12.6) | 163.9 (151.4-177.5) | -- | |
| Medium | 36 642 (24.5) | 155.1 (146.6-164.2) | -- | |
| Large | 89 811 (60.1) | 147.4 (142.8-152.2) | -- | |
| Unknown | 4236 (2.8) | 142.0 (125.6-160.6) | -- | |
| Year | <0.0001 | |||
| 2006 | 32 612 (21.8) | 120.5 (115.9-125.2) | 1349.8 (1212.5-1487.2) | |
| 2009 | 34 473 (23.1) | 128.6 (123.4-134.0) | 1426.9 (1288.1-1565.6) | |
| 2012 | 36 444 (24.4) | 151.8 (145.7-158.1) | 1508.4 (1355.9-1661.0) | |
| 2016 | 46 006 (30.8) | 217.7 (208.3-227.5) | 1904.2 (1691.9-2116.6) |
Weighted frequency counts of DKA admissions across all years (2006, 2009, 2012, 2016 Kid’s Inpatient Database) are shown; weighted column percentages reflect the prevalence of each characteristic among all DKA admissions. Two average annual DKA rates are shown. The first indicates the unadjusted number of DKA admissions per 10 000 pediatric admissions (for all causes) by characteristics included in the Kid’s Inpatient Database. The second indicates the unadjusted number of DKA admissions per 10 000 US youth with diabetes by characteristics included in the National Health Interview Survey.