Mortality attributed to hyperosmolar hyperglycaemic state (HHS) ranges from 5% to 20%.[1]Kitabchi AE, Umpierrez GE, Miles JM, et al. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009 Jul;32(7):1335-43.
http://care.diabetesjournals.org/content/32/7/1335.long
http://www.ncbi.nlm.nih.gov/pubmed/19564476?tool=bestpractice.com
[13]Mustafa OG, Haq M, Dashora U, et al. Management of hyperosmolar hyperglycaemic state (HHS) in adults: an updated guideline from the Joint British Diabetes Societies (JBDS) for Inpatient Care Group. Diabet Med. 2023 Mar;40(3):e15005.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10107355
http://www.ncbi.nlm.nih.gov/pubmed/36370077?tool=bestpractice.com
This is mostly as a consequence of the older patient population that is affected by HHS, and their comorbid conditions. Mortality in HHS is rarely caused by the metabolic complications of hyperglycaemia 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 and hypotension.[11]Kitabchi AE, Umpierrez GE, Murphy MB, et al. Hyperglycemic crises in adult patients with diabetes: a consensus statement from the American Diabetes Association. Diabetes Care. 2006 Dec;29(12):2739-48.
http://care.diabetesjournals.org/content/29/12/2739.long
http://www.ncbi.nlm.nih.gov/pubmed/17130218?tool=bestpractice.com
[14]Wachtel TJ, Silliman RA, Lamberton P. Prognostic factors in the diabetic hyperosmolar state. J Am Geriatr Soc. 1987 Aug;35(8):737-41.
http://www.ncbi.nlm.nih.gov/pubmed/3611564?tool=bestpractice.com