Diabetic Ketoacidosis: Likelihood Ratios

Introduction: Acidemia from ketone production in a state of (at least functional) hypoinsulinemia and hyperglycemia. Much more common in type 1 Diabetes Mellitus.

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Prevalence

Population / Calculator	Prevalence	Comments / Study / Link
Hyperglycemia and suspicious symptoms	14%	patients presenting to the ED; glucose > 200 and either known diabetic + DKA-like symptoms or no diabetes diagnosis Ann Emerg Med. 1999 Sep;34(3):342-6. PMID: 10459090
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The likelihood ratios of findings for Diabetic Ketoacidosis are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Good Positive and Negative Likelihood Ratios
Finding	Result	+LR	-LR
[ + ] Urine Ketones	+ 0 -	3.2	0
urine dipstick Study: Ann Emerg Med. 1999 Sep;34(3):342-6. PMID: 10459090
[ + ] Anion Gap	+ 0 -	6.1	0.1
Study: Ann Emerg Med. 1999 Sep;34(3):342-6. PMID: 10459090
[ + ] Abnormal Serum Bicarbonate	+ 0 -	84	0.2
HCO3 < 15 mEq/l Study: Ann Emerg Med. 1999 Sep;34(3):342-6. PMID: 10459090