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. 2023 Oct 13;22(1):275.
doi: 10.1186/s12933-023-02005-0.

Prognostic significance of the stress hyperglycemia ratio in critically ill patients

Le Li #  1 , Minghao Zhao #  1 , Zhuxin Zhang  1 , Likun Zhou  1 , Zhenhao Zhang  1 , Yulong Xiong  1 , Zhao Hu  1 , Yan Yao  2
Affiliations

Prognostic significance of the stress hyperglycemia ratio in critically ill patients

Le Li et al. Cardiovasc Diabetol. .

Erratum in

Abstract

Background: The stress hyperglycemia ratio (SHR) has demonstrated a noteworthy association with unfavorable cardiovascular clinical outcomes and heightened in-hospital mortality. Nonetheless, this relationship in critically ill patients remains uncertain. This study aims to elucidate the correlation between SHR and patient prognosis within the critical care setting.

Methods: A total of 8978 patients admitted in intensive care unit (ICU) were included in this study. We categorized SHR into uniform groups and assessed its relationship with mortality using logistic or Cox regression analysis. Additionally, we employed the restricted cubic spline (RCS) analysis method to further evaluate the correlation between SHR as a continuous variable and mortality. The outcomes of interest in this study were in-hospital and 1-year all-cause mortality.

Results: In this investigation, a total of 825 (9.2%) patients experienced in-hospital mortality, while 3,130 (34.9%) individuals died within the 1-year follow-up period. After adjusting for confounding variables, we identified a U-shaped correlation between SHR and both in-hospital and 1-year mortality. Specifically, within the SHR range of 0.75-0.99, the incidence of adverse events was minimized. For each 0.25 increase in the SHR level within this range, the risk of in-hospital mortality rose by 1.34-fold (odds ratio [OR]: 1.34, 95% CI: 1.25-1.44), while a 0.25 decrease in SHR within 0.75-0.99 range increased risk by 1.38-fold (OR: 1.38, 95% CI: 1.10-1.75).

Conclusion: There was a U-shaped association between SHR and short- and long-term mortality in critical ill patients, and the inflection point of SHR for poor prognosis was identified at an SHR value of 0.96.

Keywords: Critical ill; Outcomes; Restricted cubic spline; Stress hyperglycemia ratio.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart. ICU: intensive care unit; SHR: stress hyperglycemia ratio
Fig. 2
Fig. 2
The relationship between SHR and in-hospital mortality
Fig. 3
Fig. 3
Kaplan–Meier analysis for 1-year mortality based on distinct groups
Fig. 4
Fig. 4
Restricted cubic spline analysis. The U-shaped association between SHR and in-hospital mortality was observed in both (A) unadjusted model and (B) adjusted model
See this image and copyright information in PMC

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