Work

Stress hyperglycemia ratio is associated with neurological outcome after cardiac arrest

Year: 2025

Type: article

Abstract: This study examined the association between glycemic parameters, including absolute glucose and stress hyperglycemia ratio (SHR), and neurological outcomes in out-of-hospital cardiac arrest (OHCA) survivors. We conducted a retrospective analysis using data from a prospective, multicenter registry comprising 743 adult comatose OHCA survivors. Glycemic measurements (glucose and SHR) were collected following return of spontaneous circulation (ROSC) and during the subsequent 24-hour period. The primary outcome was poor neurological outcome at 6 months. Subgroup analyses were stratified by glycemic status (HbA1c) and injury severity (the revised Post-Cardiac Arrest Syndrome for Therapeutic Hypothermia score). Both absolute glucose and SHR—measured after ROSC and as 24-hour means—were independently associated with poor neurological outcomes. Among these, SHR during the 24-hour post-ROSC period showed the most substantial predictive value (OR, 2.232; 95% CI, 1.316–3.785). Spline analysis revealed a linear relationship for SHR, contrasting with the U- or J-shaped curves observed for absolute glucose values. Prognostic significance was primarily observed in patients without pre-existing diabetes and those with moderate injury severity. The SHR measured after ROSC and during the first 24 h post-resuscitation is an independent predictor of poor neurological outcome in OHCA survivors. This association is most pronounced in non-diabetic and moderate-severity groups. Kew Words: Cardiac arrest; Hyperglycaemia; Stress Hyperglycaemia Ratio; Neurological outcome.

Source: Scientific Reports

DOI: 10.1038/s41598-025-30758-z