Predictors of In-Hospital Mortality in Patients With Type 2 Diabetes Complicated by Isolated Hyperosmolar Hyperglycemic Syndrome

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/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.