Twenty-four patients suffering hyperglycemic hyperosmolar nonketotic syndrome were studied retrospectively to define initial prognostic factors. Twenty percent of these elderly patients (mean age 76 +/- 4.6 yr) had no history of diabetes, and only 54% experienced coma, which was not related to the level of plasma osmolality or to final outcome. The overall mortality was 46%, but death was directly related to nonmetabolic disorders in 64% of cases. Age; sex; acute precipitating factors (except precipitating drugs); admission levels of serum sodium, serum potassium, blood glucose, plasma osmolality, and serum creatinine; and insulin, macromolecular, and total fluid volumes infused during the first 24 h in the ICU were not related to death. The simplified acute physiology score was approximately the same for both survivors and nonsurvivors.
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