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Prognostic factors in the diabetic hyperosmolar state.
Journal of the American Geriatrics Society
|August 1, 1987
Summary
Diabetic hyperosmolar state (DHS) has a 17% mortality rate. Older age, nursing home residency, and higher serum osmolality are associated with increased mortality in DHS patients.
Area of Science:
- Endocrinology
- Internal Medicine
- Geriatrics
Background:
- Diabetic hyperosmolar state (DHS) is a serious complication of diabetes mellitus.
- Understanding factors influencing DHS outcomes is crucial for patient management.
Purpose of the Study:
- To determine the current mortality rate and associated factors in hospitalized patients with diabetic hyperosmolar state (DHS).
Main Methods:
- Retrospective study of 135 patients hospitalized with DHS over 11 years.
- Analysis of demographic, clinical, and laboratory data.
- Comparison of characteristics between survivors and non-survivors.
Main Results:
- Overall mortality rate was 17%.
- Nonsurvivors were older (mean age 77 vs 68 years) and more likely to be nursing home residents (48% vs 23%).
- Higher mean serum osmolality, blood urea nitrogen, and sodium levels were observed in patients who died.
Conclusions:
- Advanced age, nursing home residence, and severe hyperosmolality are significant predictors of mortality in DHS.
- These factors may reflect diminished physiological reserve and greater dehydration.
- Early recognition and management of DHS are critical.