The factors associated with poor survival were male sex, older age, lower bed capacity, non-academic hospital, admission in winter, higher CCI, low BMI, coma on admission, ambulance use, DIC, sepsis, renal failure, heart failure, cerebrovascular diseases, pneumonia, malignancies, anti-diabetic drugs including insulin, and corticosteroid or immunosuppressive drugs. Here, INS is linked to cerebrovascular disorder.