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Background/Aims: There is great demand for the beds in the new rehabilitation department in the authors' hospital. To determine ethical criteria for admission to the department, all senior rehabilitation physicians in the country were surveyed regarding their willingness to admit patients in various ethical scenarios. The aim was to determine whether there are consensus ethical principles governing whom to admit to the limited beds. Methods: The survey was administered to senior medical personnel responsible for admissions decisions. Out of the 54 people contacted, 30 completed the surveys (all were fully completed apart from one survey in which one clinical scenario was not answered). Results: Over 90% of respondents agreed to not admit non-compliant patients or to give precedence to those who were considered to be very important people, and 88% agreed on admitting a homeless patient. First come, first served was not considered an important criterion. Cronbach's alpha was <0.6. There was no consensus on most of the issues presented. Conclusions: It remains difficult to pinpoint what rehabilitation physicians consider ethical 'givens'. This research suggests that no specific ethical principle underlying the triage decisions in rehabilitative medicine can be discerned. Larger studies are warranted. Implications for practice: No ethically or specific principle underlying the triage decisions in rehabilitative medicine can be discerned. What one doctor may consider a clear ethical decision another physician may not concur. [ABSTRACT FROM AUTHOR]

Aims: To assess the clinical features and outcomes of patients diagnosed with DKA who were hospitalized for conditions outside of internal medicine., Methods: Retrospective analysis of admissions for DKA in adult patients between 2005 and 2022 at a tertiary hospital in Israel. Patients with DKA were stratified into medical vs non-medical groups, the primary outcome was in-hospital mortality., Results: 429 patients were included in the study, 385 patients (89.7 %) were treated by an internal medicine team, while 44 patients (10.3 %) were hospitalized with surgical or obstetrical conditions. Patients in the non-internal medicine group were older (52 ± 18.9 vs 43.6 ± 20.4, p < 0.005) and had higher rates of diabetes complications such as chronic ischemic heart disease (20.5 % vs. 4.2 %, p < 0.0001) and chronic kidney disease (50 % vs. 3.4 %, p < 0.001). Glucose level on presentation was lower for non-internal medicine patients (398 ± 221 mg/dL vs 551 ± 180 mg/dL) and outcomes of mechanical ventilation and length of hospitalization were more severe (29.5 % vs. 6 %, p < 0.001 and 8.0 vs. 3.0, p < 0.001). Multivariate analysis demonstrated that composite outcome of in-hospital mortality, ICU admission and longer hospitalization was more likely in the non-internal medicine group (OR 3.99, CI 1.89-8.4, p < 0.001)., Conclusion: DKA is a universal pathology that concerns various medical fields. It is essential for every clinician to be familiar with this condition. Patients diagnosed with DKA who were hospitalized for conditions outside of internal medicine may be at high risk and may present with lower glycemic levels. Future research is needed to characterize the unique features of subgroups of patients with DKA., Competing Interests: Declaration of competing interest This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Diabetic ketoacidosis (DKA) is an acute metabolic, life-threatening complication of diabetes mellitus with a mortality rate that now stand at less than 1%. Although mortality is coupled with the etiology of DKA, literature on the influence of DKA etiology on patient outcome is scarce., Objectives: To study different triggers for DKA and their effect on outcomes., Methods: We conducted a retrospective study that include 385 DKA patients from 2004 to 2017. The study compared demographics, clinical presentation, and mortality rates by different precipitating factors., Results: Patients with DKA due to infections had a higher risk to develop in-hospital mortality after controlling for age and sex (odds ratio 4.40, 95% confidence interval 1.35-14.30), had a higher Charlson Comorbidity Index score, a higher risk of being mechanical ventilated (14% vs. 3%, P < 0.01), and a longer duration of hospitalization (5 days vs. 3 days, P < 0.001)., Conclusions: It is crucial to find the triggers that precipitate DKA and start the treatment as early as possible in addition to the metabolic aspect of the treatment especially when the trigger is an infectious disease.