Abstract: Objective To investigate the clinical characteristics and prognosis of dialetic ketoacidosis (DKA) in the elderly. Methods We conducted a retrospective analysis of adult patients with DKA admitted in Wuxi People’s Hospital Affiliated Nanjing Medical University from January 2009 to December 2018. The DKA patients were categorized by age into the young and middle-aged group(younger than 60 years) and the elderly group(60 years and older). The clinical features and prognosis of DKA patients were collected and compared between the two groups. Results During the decade, we observed 66 patients(19.5%) in the elderly group and 273 patients(80.5%) in the young and middle-aged group. The elderly group had a higher incidence rate of onset diabetes(P<0.05). Except for no obvious predisposing cause(34.8%), infections and non-compliance to insulin therapy were the two most frequent precipitating factors of DKA. The DKA severity of patients in the elderly group was lower than that in the young and middle-aged group(Z=-2.736, P=0.006), however,they had higher incidence rate of cardiovascular diseases, hyperosmotic status and pulmonary infection(P<0.05). The incidence rate of hypoglycemia in the elderly group was significantly higher than that in the young and middle-aged group, while the time to correct pH was shorter than that in the young and middle-aged group(P<0.05). The length of hospital stay was similar in both groups, but long-term prognosis in the elderly group was worse. Conclusions DKA is often the presenting symptom of new-onset diabetes in the elderly. The severity of DKA in the elderly is lower than that in young and middle-aged patients. However elderly patients with DKA are more likely to have comorbidities, hypoglycemia and poor long-term prognosis. It’s necessary to pay more attention to diagnosis and treatment of the comorbidities of elderly patients with DKA.

Key words: diabetic ketoacidosis, aged, clinic characteristics, prognosis