Prognosis

Reported mortality rates in hyperosmolar hyperglycemic state (HHS) vary.[1] In the US, from 2008 to 2018, there was a reported increase in hospitalizations for HHS in patients with type 2 diabetes; however, inpatient mortality decreased from 1.44% to 0.77%.[16]​ Mortality rates are higher in low- and middle-income countries, with rates reported up to 20.3% in Jamaica.[17]

Mortality in HHS is rarely caused by the metabolic complications of hyperglycemia, but rather relates to the underlying illness. The prognosis of HHS is worsened substantially at the extremes of age and in the presence of coma, hypotension, and severe comorbidities.​[8][46]

Reported mortality rates are higher for patients with mixed diabetic ketoacidosis (DKA)/HHS compared with DKA or HHS alone.[1][5]​​​

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