The incidence of cerebral edema in pediatric patients with diabetic ketoacidosis: a retrospective study

Abstract Objective Cerebral edema is a severe and potentially fatal complication of diabetic ketoacidosis (DKA), particularly in pediatric patients. Despite its clinical significance, limited data exist on its incidence and associated risk factors in resource-limited settings. This study aimed to de...

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Main Authors: Sara Memarian, Ali Zolfaghari, Behdad Gharib, Mohammad Mehdi Rajabi
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Research Notes
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Online Access:https://doi.org/10.1186/s13104-025-07237-9
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author Sara Memarian
Ali Zolfaghari
Behdad Gharib
Mohammad Mehdi Rajabi
author_facet Sara Memarian
Ali Zolfaghari
Behdad Gharib
Mohammad Mehdi Rajabi
author_sort Sara Memarian
collection DOAJ
description Abstract Objective Cerebral edema is a severe and potentially fatal complication of diabetic ketoacidosis (DKA), particularly in pediatric patients. Despite its clinical significance, limited data exist on its incidence and associated risk factors in resource-limited settings. This study aimed to determine the incidence of cerebral edema in pediatric patients with DKA and investigate potential contributing factors. This retrospective study analyzed data from 270 pediatric DKA patients admitted to the Children’s Medical Center Hospital, Tehran, between March 2018 and March 2020. Patients aged 1 day to 18 years were included based on standard DKA diagnostic criteria (blood glucose > 250 mg/dL, pH < 7.3, bicarbonate < 18 mEq/L, and ketonemia/ketonuria). Patients with incomplete records or pre-existing neurological conditions were excluded. The statistical analyses included independent t-tests and Fisher’s exact tests. Results The incidence of cerebral edema was 6.67%. Elevated blood glucose levels at admission were significantly associated with cerebral edema (P = 0.01), suggesting a potential role in its pathophysiology. Additionally, a strong correlation was observed between cerebral edema and ICU admission (P < 0.001), indicating a more severe disease course. The results suggest that early glucose control and neurological monitoring are critical for preventing adverse outcomes such as cerebral edema in pediatric DKA patients.
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spelling doaj-art-75063efc3c044acc8a0fc4b904f584012025-08-20T02:11:58ZengBMCBMC Research Notes1756-05002025-04-011811510.1186/s13104-025-07237-9The incidence of cerebral edema in pediatric patients with diabetic ketoacidosis: a retrospective studySara Memarian0Ali Zolfaghari1Behdad Gharib2Mohammad Mehdi Rajabi3Children’s Medical Center, Tehran University of Medical SciencesChildren’s Medical Center, Tehran University of Medical SciencesChildren’s Medical Center, Tehran University of Medical SciencesDepartment of Pediatric Nursing and Neonatal Intensive Care, School of Nursing and Midwifery, Tehran University of Medical SciencesAbstract Objective Cerebral edema is a severe and potentially fatal complication of diabetic ketoacidosis (DKA), particularly in pediatric patients. Despite its clinical significance, limited data exist on its incidence and associated risk factors in resource-limited settings. This study aimed to determine the incidence of cerebral edema in pediatric patients with DKA and investigate potential contributing factors. This retrospective study analyzed data from 270 pediatric DKA patients admitted to the Children’s Medical Center Hospital, Tehran, between March 2018 and March 2020. Patients aged 1 day to 18 years were included based on standard DKA diagnostic criteria (blood glucose > 250 mg/dL, pH < 7.3, bicarbonate < 18 mEq/L, and ketonemia/ketonuria). Patients with incomplete records or pre-existing neurological conditions were excluded. The statistical analyses included independent t-tests and Fisher’s exact tests. Results The incidence of cerebral edema was 6.67%. Elevated blood glucose levels at admission were significantly associated with cerebral edema (P = 0.01), suggesting a potential role in its pathophysiology. Additionally, a strong correlation was observed between cerebral edema and ICU admission (P < 0.001), indicating a more severe disease course. The results suggest that early glucose control and neurological monitoring are critical for preventing adverse outcomes such as cerebral edema in pediatric DKA patients.https://doi.org/10.1186/s13104-025-07237-9Diabetic ketoacidosisCerebral edemaPediatricHyperglycemia
spellingShingle Sara Memarian
Ali Zolfaghari
Behdad Gharib
Mohammad Mehdi Rajabi
The incidence of cerebral edema in pediatric patients with diabetic ketoacidosis: a retrospective study
BMC Research Notes
Diabetic ketoacidosis
Cerebral edema
Pediatric
Hyperglycemia
title The incidence of cerebral edema in pediatric patients with diabetic ketoacidosis: a retrospective study
title_full The incidence of cerebral edema in pediatric patients with diabetic ketoacidosis: a retrospective study
title_fullStr The incidence of cerebral edema in pediatric patients with diabetic ketoacidosis: a retrospective study
title_full_unstemmed The incidence of cerebral edema in pediatric patients with diabetic ketoacidosis: a retrospective study
title_short The incidence of cerebral edema in pediatric patients with diabetic ketoacidosis: a retrospective study
title_sort incidence of cerebral edema in pediatric patients with diabetic ketoacidosis a retrospective study
topic Diabetic ketoacidosis
Cerebral edema
Pediatric
Hyperglycemia
url https://doi.org/10.1186/s13104-025-07237-9
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