Mortality in hyperglycemic crisis: a high association with infections and cerebrovascular disease

Minerva Endocrinol. 2013 Jun;38(2):187-93.


Aim: Aim of the present study was to determine syndrome specific mortality rates and the precipitating factors associated with deaths following admission for hyperglycemic crisis to a high care unit.

Methods: Retrospective review of medical records for hyperglycemic crisis at Nelson Mandela Academic Hospital, Mthatha, Eastern Cape Province of South Africa from February 1 2010 to January 31 2011. All admissions were initially into the high care unit.

Results: The overall mortality rates (per admissions) was 13.9% (N.=15/108) with syndrome specific mortality rates (per admissions) of 11.9% (N.=8/67), 0% (N.=0/8) and 21.2% (N.=7/33) respectively for diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state (HHS) and hyperglycemia with dehydration (HD). The precipitating factors that were mainly associated with mortality were infections and cerebrovascular disease (CVD). The patients with CVD who died were all unconscious. There were no deaths where non-compliance with hypoglycaemic agents (14.8%, N.=16/108) was the precipitating factor.

Conclusion: The overall mortality rates (per admissions) following high care unit admissions for hyperglycemic crisis was 13.9% with infections and CVD as the precipitating factors most associated with deaths.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Glucose / metabolism
  • Cerebrovascular Disorders / complications*
  • Cerebrovascular Disorders / mortality*
  • Child
  • Female
  • Humans
  • Hyperglycemia / complications*
  • Hyperglycemia / mortality*
  • Infections / complications*
  • Infections / mortality*
  • Length of Stay
  • Male
  • Middle Aged
  • Retrospective Studies
  • South Africa / epidemiology
  • Young Adult


  • Blood Glucose