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. 2024 May 21:15:1383993.
doi: 10.3389/fendo.2024.1383993. eCollection 2024.

Impact of stress hyperglycemia ratio on mortality in patients with cardiac arrest: insight from American MIMIC-IV database

Li-You Lian  1 , Wei-Hao Xue  2 , Jia-Jia Lu  3 , Ru-Jie Zheng  4
Affiliations

Impact of stress hyperglycemia ratio on mortality in patients with cardiac arrest: insight from American MIMIC-IV database

Li-You Lian et al. Front Endocrinol (Lausanne). .

Abstract

Background: Stress hyperglycemia ratio (SHR) has shown a predominant correlation with transient adverse events in critically ill patients. However, there remains a gap in comprehensive research regarding the association between SHR and mortality among patients experiencing cardiac arrest and admitted to the intensive care unit (ICU).

Methods: A total of 535 patients with their initial ICU admission suffered cardiac arrest, according to the American Medical Information Mart for Intensive Care (MIMIC)-IV database. Patients were stratified into four categories based on quantiles of SHR. Multivariable Cox regression models were used to evaluate the association SHR and mortality. The association between SHR and mortality was assessed using multivariable Cox regression models. Subgroup analyses were conducted to determine whether SHR influenced ICU, 1-year, and long-term all-cause mortality in subgroups stratified according to diabetes status.

Results: Patients with higher SHR, when compared to the reference quartile 1 group, exhibited a greater risk of ICU mortality (adjusted hazard ratio [aHR] = 3.029; 95% CI: 1.802-5.090), 1-year mortality (aHR = 3.057; 95% CI: 1.885-4.958), and long-term mortality (aHR = 3.183; 95% CI: 2.020-5.015). This association was particularly noteworthy among patients without diabetes, as indicated by subgroup analysis.

Conclusion: Elevated SHR was notably associated with heightened risks of ICU, 1-year, and long-term all-cause mortality among cardiac arrest patients. These findings underscore the importance of considering SHR as a potential prognostic factor in the critical care management of cardiac arrest patients, warranting further investigation and clinical attention.

Keywords: cardiac arrest; diabetes; mortality; prognosis; stress hyperglycemia ratio.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study flowchart. SHR, stress hyperglycemia ratio; ICU, intensive care unit.
Figure 2
Figure 2
Kaplan-Meier survival curve of survival probability in cardiac arrest patients in ICU mortality (A), 1-year mortality (B) and long-term mortality (C). SHR, stress hyperglycemia ratio; ICU, intensive care unit.
Figure 3
Figure 3
Subgroup analysis for the association of SHR with in ICU mortality, 1-year mortality and overall death. SHR, stress hyperglycemia ratio; ICU, intensive care unit; HR, hazard ratio; CI, confidence interval.
See this image and copyright information in PMC

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