title: Characteristics and outcomes of the hyperglycemic hyperosmolar non-ketotic syndrome in a cohort of 51 consecutive cases at a single center.
abstract: OBJECTIVE
  The hyperglycemic hyperosmolar syndrome (HHS) is a life-threatening diabetic complication. We aimed to portrait the short and long term outcome after a HHS episode and to describe features associated with increased early mortality.
  
  
  METHODS
  We collected data from consecutive HHS cases, defined based on rigorous glucose and osmolality criteria. We retrieved anthropometric measures, history of diabetes, other cardiovascular risk factors and chronic co-morbidity. Clinical and biochemical parameters were recorded at admission, after 24h and at discharge. We assessed incidence of complications, as well as short (≤ 30 days) and long term mortality.
  
  
  RESULTS
  Patients were about 80-year old. Fifty-one cases were included, characterized by severe hyperglycemia (55.5 mosm/L) and hyperosmolality (385 mosm/L). Thirty-three percent developed at least one complication. Short term mortality was 16%; lower Glasgow Coma Scale, higher plasma glucose and mild acidosis were predictive of short term mortality. The long term mortality (median follow-up 1.27 years) was not significantly different from historical mortality data after hypoglycemic coma.
  
  
  CONCLUSIONS
  In this study, early mortality of HHS was 16% and some clinical features at presentation were predictive of an adverse short term outcome. Long term survival after a HHS episode did not appear to be severely impaired.
authors.affiliation: Division of Metabolic Diseases, Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy. gianpaolofadini@hotmail.com
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Fadini
authors.forename: Saula Vigili
authors.initials: SV
authors.lastname: de Kreutzenberg
authors.forename: Mauro
authors.initials: M
authors.lastname: Rigato
authors.forename: Stefano
authors.initials: S
authors.lastname: Brocco
authors.forename: Maria
authors.initials: M
authors.lastname: Marchesan
authors.forename: Antonio
authors.initials: A
authors.lastname: Tiengo
authors.forename: Angelo
authors.initials: A
authors.lastname: Avogaro
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006944:Hyperglycemic Hyperosmolar Nonketotic Coma / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy; D007558:Italy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers