Association between stress hyperglycemia ratio and all-cause mortality in critically ill patients with sepsis: results from the MIMIC-IV database
Abstract Background This study aimed to explore the association between the stress hyperglycemia ratio (SHR) and short- and long-term outcomes in critically ill patients with sepsis. Methods This retrospective observational cohort study was conducted using the Medical Information Mart for Intensive...
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BMC
2025-01-01
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| Series: | European Journal of Medical Research |
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| Online Access: | https://doi.org/10.1186/s40001-025-02281-4 |
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| author | Shijie Zhang Hechen Shen Yuchao Wang Meng Ning Jianghui Zhou Xiaoyu Liang Yun Chang Wenqing Gao Tong Li |
| author_facet | Shijie Zhang Hechen Shen Yuchao Wang Meng Ning Jianghui Zhou Xiaoyu Liang Yun Chang Wenqing Gao Tong Li |
| author_sort | Shijie Zhang |
| collection | DOAJ |
| description | Abstract Background This study aimed to explore the association between the stress hyperglycemia ratio (SHR) and short- and long-term outcomes in critically ill patients with sepsis. Methods This retrospective observational cohort study was conducted using the Medical Information Mart for Intensive Care-IV (MIMIC-IV v2.2) database. Patients were categorized into 4 SHR quartiles. The main focus was on in-hospital mortality and 1-year all-cause mortality as primary endpoints, while intensive care unit and hospital stays were considered as secondary outcomes. Regression and subgroup analyses were used to assess the correlation between SHR and the primary and secondary outcomes. Restricted cubic spline analysis was utilized to explore the nonlinear relationships between SHR and in-hospital and 1-year all-cause mortality. Results This study included two groups of patients, comprising 7456 and 6564 individuals. The in-hospital and 1-year mortality was 11.96% and 17.96% in Cohort 1 and 2, respectively. SHR was associated with an elevated risk of in-hospital mortality (OR: 2.08, 95%CI 1.66–2.61) and 1-year mortality (HR: 1.70, 95% CI 1.42–2.04). Patients in SHR quartile 4 had a higher risk of in-hospital (OR: 1.86, 95% CI 1.51–2.30) and 1-year (HR: 1.44, 95% CI 1.23–1.69) mortality than those in quartile 2. Restricted cubic spline analysis showed a “J-shaped” relationship between SHR and all-cause mortality in both cohorts. The relationship between high SHR and mortality remained consistent across almost all predefined subgroups. Conclusions Our study suggests that high SHR is associated with increased in-hospital and 1-year mortality in critically ill sepsis patients. Further investigations are needed to validate these results. |
| format | Article |
| id | doaj-art-87e9304e610c4b309ae5958d11b257c7 |
| institution | Kabale University |
| issn | 2047-783X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj-art-87e9304e610c4b309ae5958d11b257c72025-01-26T12:21:42ZengBMCEuropean Journal of Medical Research2047-783X2025-01-0130111110.1186/s40001-025-02281-4Association between stress hyperglycemia ratio and all-cause mortality in critically ill patients with sepsis: results from the MIMIC-IV databaseShijie Zhang0Hechen Shen1Yuchao Wang2Meng Ning3Jianghui Zhou4Xiaoyu Liang5Yun Chang6Wenqing Gao7Tong Li8School of Medicine, Nankai UniversityThe Third Central, Clinical College of Tianjin Medical UniversitySchool of Medicine, Nankai UniversityDepartment of Heart Center, The Third Central Hospital of TianjinThe Third Central, Clinical College of Tianjin Medical UniversityDepartment of Heart Center, The Third Central Hospital of TianjinDepartment of Heart Center, The Third Central Hospital of TianjinDepartment of Heart Center, The Third Central Hospital of TianjinSchool of Medicine, Nankai UniversityAbstract Background This study aimed to explore the association between the stress hyperglycemia ratio (SHR) and short- and long-term outcomes in critically ill patients with sepsis. Methods This retrospective observational cohort study was conducted using the Medical Information Mart for Intensive Care-IV (MIMIC-IV v2.2) database. Patients were categorized into 4 SHR quartiles. The main focus was on in-hospital mortality and 1-year all-cause mortality as primary endpoints, while intensive care unit and hospital stays were considered as secondary outcomes. Regression and subgroup analyses were used to assess the correlation between SHR and the primary and secondary outcomes. Restricted cubic spline analysis was utilized to explore the nonlinear relationships between SHR and in-hospital and 1-year all-cause mortality. Results This study included two groups of patients, comprising 7456 and 6564 individuals. The in-hospital and 1-year mortality was 11.96% and 17.96% in Cohort 1 and 2, respectively. SHR was associated with an elevated risk of in-hospital mortality (OR: 2.08, 95%CI 1.66–2.61) and 1-year mortality (HR: 1.70, 95% CI 1.42–2.04). Patients in SHR quartile 4 had a higher risk of in-hospital (OR: 1.86, 95% CI 1.51–2.30) and 1-year (HR: 1.44, 95% CI 1.23–1.69) mortality than those in quartile 2. Restricted cubic spline analysis showed a “J-shaped” relationship between SHR and all-cause mortality in both cohorts. The relationship between high SHR and mortality remained consistent across almost all predefined subgroups. Conclusions Our study suggests that high SHR is associated with increased in-hospital and 1-year mortality in critically ill sepsis patients. Further investigations are needed to validate these results.https://doi.org/10.1186/s40001-025-02281-4Stress hyperglycemia ratioMortalitySepsisMIMIC-IV databaseDiabetes |
| spellingShingle | Shijie Zhang Hechen Shen Yuchao Wang Meng Ning Jianghui Zhou Xiaoyu Liang Yun Chang Wenqing Gao Tong Li Association between stress hyperglycemia ratio and all-cause mortality in critically ill patients with sepsis: results from the MIMIC-IV database European Journal of Medical Research Stress hyperglycemia ratio Mortality Sepsis MIMIC-IV database Diabetes |
| title | Association between stress hyperglycemia ratio and all-cause mortality in critically ill patients with sepsis: results from the MIMIC-IV database |
| title_full | Association between stress hyperglycemia ratio and all-cause mortality in critically ill patients with sepsis: results from the MIMIC-IV database |
| title_fullStr | Association between stress hyperglycemia ratio and all-cause mortality in critically ill patients with sepsis: results from the MIMIC-IV database |
| title_full_unstemmed | Association between stress hyperglycemia ratio and all-cause mortality in critically ill patients with sepsis: results from the MIMIC-IV database |
| title_short | Association between stress hyperglycemia ratio and all-cause mortality in critically ill patients with sepsis: results from the MIMIC-IV database |
| title_sort | association between stress hyperglycemia ratio and all cause mortality in critically ill patients with sepsis results from the mimic iv database |
| topic | Stress hyperglycemia ratio Mortality Sepsis MIMIC-IV database Diabetes |
| url | https://doi.org/10.1186/s40001-025-02281-4 |
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