ArticleMedical science monitor : international medical journal of experimental and clinical research2026
Predictors of In-Hospital Mortality in Patients With Type 2 Diabetes Complicated by Isolated Hyperosmolar Hyperglycemic Syndrome.
Article in Medical science monitor : international medical journal of experimental and clinical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND Hyperosmolar hyperglycemic syndrome (HHS) carries a high in-hospital mortality rate. Identifying its in-hospital mortality risk factors is crucial for improving patient outcomes. This study aims to investigate the predictors of in-hospital mortality in patients with type 2 diabetes (T2DM) complicated by isolated HHS. MATERIAL AND METHODS A retrospective analysis was conducted on 102 patients with isolated HHS complicated by T2DM, who were divided into non-survivors (30 cases) and survivors (72 cases) based on in-hospital outcomes. A comparative assessment of clinical characteristics and laboratory findings was performed. Variables with P<0.05 in the univariate logistic regression were entered into the multivariate model to determine independent predictors of mortality. Significant factors identified in the multivariate analysis (P<0.05) were subsequently incorporated into the construction of a mortality prediction model. RESULTS The in-hospital mortality rate was 29.4%. Multivariate logistic regression identified elevated blood urea nitrogen (OR=1.103, 95% CI: 1.021-1.193), cystatin C (OR=1.745, 95% CI: 1.031-2.953), D-dimer (OR=1.058, 95% CI: 1.001-1.118), and Charlson Comorbidity Index score (OR=2.679, 95% CI: 1.257-5.710) as independent predictors of mortality (all P<0.05). Prophylactic administration of low molecular weight heparin (LMWH) was associated with a reduced risk of death (OR=0.033, 95% CI: 0.004-0.302). Receiver operating characteristic analysis demonstrated that cystatin C had the greatest discriminative value (AUC=0.899), with an optimal cut-off of 3.73 mg/L, yielding 80% sensitivity and 91.7% specificity. CONCLUSIONS Elevated blood urea nitrogen, cystatin C, D-dimer levels, and higher Charlson Comorbidity Index scores were identified as independent predictors of in-hospital mortality in patients with T2DM complicated by isolated HHS, whereas prophylactic administration of LMWH was associated with improved survival.
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