Fatores Prognósticos Associados à Reinternação e Recorrência da Cetoacidose Diabética: Revisão Integrativa
DOI:
https://doi.org/10.47224/revistamaster.v11i21.850Keywords:
Patient readmission, Prognostic factors, Social determinants of health, Diabetic ketoacidosis, Quality of health care.Abstract
Hospital readmission is a relevant indicator of healthcare quality and is associated with increased morbidity, mortality, and healthcare costs. This integrative review aimed to identify prognostic factors associated with hospital readmission across different clinical settings, comparing the nature of predictors and their potential preventability.
A systematic search was conducted in the PubMed, Semantic Scholar, SciELO, and Google Scholar databases, and five primary studies were selected, addressing readmission after coronary artery bypass grafting, diabetic ketoacidosis in adults and children, post-infarction heart failure, and intensive care unit readmission.
The results demonstrated that age is a universal predictor of readmission; however, its effect direction varies depending on the clinical context, with advanced age in cardiovascular and intensive care settings and younger age in diabetic ketoacidosis. Social determinants of health emerged as the factors with the greatest magnitude of effect, particularly African American race, homelessness, and substance abuse in the recurrence of diabetic ketoacidosis, with adjusted odds ratios exceeding those of traditional clinical variables.
Pharmacological underutilization at hospital discharge and the absence of structured transitional care programs were also identified.
In conclusion, hospital readmission is a multifactorial phenomenon that transcends the clinical dimension and is strongly influenced by social vulnerabilities and the quality of care during the transition from hospital to home.
Downloads
References
SHAKA, H.; AGUILERA, M.; AUCAR, M.; et al. Rate and predictors of 30-day readmission following diabetic ketoacidosis in type 1 diabetes mellitus: a US analysis. Journal of Clinical Endocrinology and Metabolism, v. 106, n. 9, p. 2592–2601, 2021. DOI: 10.1210/clinem/dgab372.
SHAKA, H.; DEHART, L.; EL-AMIR, Z.; et al. Rising readmission rates after diabetic ketoacidosis hospitalization among adults with type 1 diabetes throughout a decade in the United States. Clinical Diabetes, 2022. DOI: 10.2337/cd22-0008.
LYERLA, R. C.; JOHNSON-RABBETT, B. E.; SHAKALLY, A.; et al. Recurrent DKA results in high societal costs: a retrospective study identifying social predictors of recurrence for potential future intervention. Clinical Diabetes and Endocrinology, v. 7, 2021. DOI: 10.1186/s40842-021-00127-6.
GOLBETS, E.; BRANDSTAETTER, E.; SAGY, I.; et al. Predictors and outcomes of recurrent diabetic ketoacidosis in Israeli adults. Diabetes & Metabolic Syndrome, v. 15, n. 5, 2021. DOI: 10.1016/j.dsx.2021.102276.
HASHMI, S. S. H.; BAHTIYAR, G.; RODRIGUEZ, G.; et al. Interventional study to reduce the readmission rate in type 1 diabetics hospitalized for diabetic ketoacidosis. Journal of the Endocrine Society, v. 6, suppl. 1, p. A322, 2022. DOI: 10.1210/jendso/bvac150.668.
ONWUDIWE, O.; YERASHEVICH, L.; ONWUDIWE, C.; et al. Predictors of hospital readmission within three months among patients admitted for diabetic ketoacidosis (DKA). Journal of the Endocrine Society, v. 8, suppl. 1, 2024. DOI: 10.1210/jendso/bvae163.893.
RAMOS, T. T. O.; NORONHA, J. A. F.; LINS, B. S.; et al. Cetoacidose diabética em crianças e adolescentes com diabetes mellitus tipo 1 e fatores de risco associados. Cogitare Enfermagem, v. 27, 2022. DOI: 10.5380/ce.v27i0.82388.
SCHWARTZ, D. D.; ERRAGUNTLA, M.; DESALVO, D. J.; et al. Severe and recurrent diabetic ketoacidosis in children and youth with type 1 diabetes: risk and protective factors. Diabetes Technology and Therapeutics, 2025. DOI: 10.1089/dia.2025.0128.
KOHLENBERG, J. D.; XU, M.; COOPERGARD, R.; et al. The development and validation of multivariable electronic health record-based models to predict diabetic ketoacidosis-related hospitalizations for adults with type 1 diabetes. Diabetes Technology and Therapeutics, 2025. DOI: 10.1177/15209156251387161.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Revista Master - Ensino, Pesquisa e Extensão
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Política para Periódicos de Acesso Livre
Autores que publicam nesta revista concordam com os seguintes termos:
a) A licença desses direitos autorais abrange o direito exclusivo da Revista Master - Ensino, Pesquisa e Extensão para reproduzir, publicar e distribuir o artigo,
nacional e internacionalmente, incluindo reimpressões, traduções, reproduções fotográficas, microformas, formulários eletrônicos (offline, on-line) ou qualquer outra reprodução de natureza similar.
b) O (s) autor (es) aprovam que o manuscrito não pode ser retirado ou reenviado para qualquer outro Jornal/Revista enquanto a avaliação pelos pares estiver em andamento. Após aprovado o manuscrito, um autor pode auto-arquivar uma versão de seu artigo em seu próprio site e/ou em seu repositório institucional.
c) O (s) autor (es) declaram que são integralmente responsáveis pela totalidade do conteúdo da contribuição e que a Revista Master - Ensino, Pesquisa e Extensão e o corpo editorial da Revista Científica do estão expressamente isentos de qualquer responsabilidade sobre o conteúdo do artigo, métodos, técnicas e resultados de sua pesquisa, tendo, assim, finalidade meramente informativa e educativa.
d) Autores têm autorização para assumir contratos adicionais separadamente, para distribuição não-exclusiva da versão do trabalho publicada nesta revista (ex.: publicar em repositório institucional ou como capítulo de livro), com reconhecimento de autoria e publicação inicial nesta revista.
