Prevalence of treatment outcomes and associated factors of diabetic ketoacidosis among adult diabetic patients admitted to Debre Markos comprehensive specialized hospital, Northwest Ethiopia: A cross-sectional study

Background Diabetic ketoacidosis emergencies are serious acute complications of diabetes mellitus, and their health and economic impacts have been increasing among adult diabetic patients. Despite the growing burden of emergencies from diabetic ketoacidosis among adults with diabetes, its outcome and predictors of treatment have not been well studied in Ethiopia. Objective To assess the prevalence of poor treatment outcome of diabetic ketoacidosis and associated factors among adult diabetic patients admitted to the Debre Markos comprehensive specialized hospital, northwest Ethiopia. Methods A hospital-based cross-sectional study was conducted at Debre Markos comprehensive specialized hospital from April 8, 2025 to April 28, 2025. A total of 360 patients with diabetic DKA who were admitted from August 28, 2019 to September 30, 2024 participated in the study. A simple random sampling technique was used to select study participants. Data were extracted using a pre-tested data collection tool adapted from different literatures. The data were entered into epi-data version 4.6.0 and exported to SPSS version 26 for analysis. Both bivariable and multivariable binary logistic regression analysis were done. Statistical significance was declared at a p-value < 0.05 with an odds ratio of 95% confidence interval. Results The prevalence of poor treatment outcomes was 15.5% (95%, CI: 11.5%, 19.3%). Factors, such as severe DKA (AOR: 1.482, 95% CI: 1.324, 4.872), the presence of comorbidities (AOR: 1.752, 95% CI: 1.215, 3.865), and underlying infections (95% CI: 1.362, 4.125), discontinuation of drugs (AOR: 2.115, 95% CI: 1.245, 3.865), treatment complications (AOR: 1.356, 95% CI: 1.253, 4.125), ketone levels > 3 (AOR: 1.213, 95% CI: 1.052, 2.876), and hospital stays of less than five days (AOR: 1.29, 95% CI: 1.022, 3.254) were also significant predictors of poor outcomes in patients with DKA. Conclusions This study found that a high number of patients with DKA in the Debre Markos comprehensive specialized hospital experienced poor treatment outcomes. Significant factors included severe DKA, comorbidities, infections, drug discontinuation, treatment complications, high ketone levels and short hospital stays. To improve treatment outcomes, early identification and proactive management of high-risk DKA patients, particularly those who present with severe illness, comorbidity conditions, or infections, shall be prioritized.