Work

Stress hyperglycemia ratio and mortality in critically ill patients with heart failure: a retrospective cohort study from the MIMIC-IV database

Year: 2025

Type: article

Abstract: BACKGROUND: The stress hyperglycemia ratio (SHR) was created to reduce the impact of long-term chronic glycemic factors on stress hyperglycemia, which is considered a reliable biomarker for adverse outcomes in intensive care patients. However, the relationship between SHR and the outcomes for critically ill patients with heart failure (HF) remains unclear. METHODS: This retrospective cohort study analyzed 1,438 critically ill patients with HF from the Medical Information Mart for Intensive Care IV (MIMIC-IV, v3.1) database (2008–2022). Patients were followed from ICU admission to death or 365days. SHR was calculated as admission glucose (mmol/L) / [1.59 × HbA1c (%) − 2.59]. Multivariable Cox regression with four adjustment levels evaluated the association between SHR and mortality. Restricted cubic splines assessed nonlinear relationships, and Kaplan-Meier methodology with log-rank tests analyzed survival patterns. RESULTS: In the cohort, each 1-unit increase in SHR was associated with a 40% higher 30-day mortality risk (HR 1.40, 95% CI 1.20–1.63, P < 0.001) and a 31% higher 90-day mortality risk (HR 1.31, 95% CI 1.14–1.51, P < 0.001). Patient survival rates decreased significantly with higher SHR tertiles (P < 0.001), and restricted cubic spline analysis confirmed a linear relationship. Subgroup analyses confirmed the robustness of these links. CONCLUSIONS: Elevated SHR is significantly associated with increased mortality in critically ill patients with HF, supporting its role as a valuable biomarker for risk stratification in this high-risk population.

Source: BMC Cardiovascular Disorders

DOI: 10.1186/s12872-025-05257-8

Authors: Guibao Jiang, Erjing Cheng, Liya Pan, Jianqiang Li, Rong Ding

Institutions: Shanxi Medical University, Second Hospital of Shanxi Medical University, Wenzhou Medical University, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University

Language: English

Topic: Hyperglycemia and glycemic control in critically ill and hospitalized patients

Subfield: Endocrinology, Diabetes and Metabolism

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,090