Stress hyperglycemia ratio association with all-cause mortality in critically ill patients with coronary heart disease: an analysis of the MIMIC-IV database
Abstract Background The stress hyperglycemia ratio (SHR) indicates relative hyperglycemia levels. Research on the impact of SHR on mortality in coronary heart disease (CHD) patients in intensive care is limited. This study explores the predictive accuracy of SHR for the prognosis of CHD patients in...
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Nature Portfolio
2024-11-01
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| author | Xiaofang Chen Zewen Yang Rui Shi Xiaoyan Wang Xuhua Li |
| author_facet | Xiaofang Chen Zewen Yang Rui Shi Xiaoyan Wang Xuhua Li |
| author_sort | Xiaofang Chen |
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| description | Abstract Background The stress hyperglycemia ratio (SHR) indicates relative hyperglycemia levels. Research on the impact of SHR on mortality in coronary heart disease (CHD) patients in intensive care is limited. This study explores the predictive accuracy of SHR for the prognosis of CHD patients in the ICU. Methods This study included 2,059 CHD patients from the American Medical Information Mart for Intensive Care (MIMIC-IV) database. SHR was determined using the formula: SHR = (admission glucose) (mmol/L) / (1.59 * HbA1c [%] – 2.59). Subjects were stratified into quartiles based on SHR levels to examine the correlation between SHR and in-hospital mortality. The restricted cubic splines and Cox proportional hazards models were employed to assess this association, while Kaplan-Meier survival analysis was executed to ascertain the mortality rates across the SHR quartiles. Results Among the 2059 participants (1358 men), the rates of in-hospital and ICU mortality were 8.5% and 5.25%, respectively. Analysis showed SHR as a significant predictor of increased risk for both in-hospital (HR,1.16, 95% CI: 1.02–1.32, P = 0.022) and ICU mortality (HR, 1.16, 95% CI: 1.01–1.35, P = 0.040) after adjustments. A J-shaped relationship was noted between SHR and mortality risks (p for non-linearity = 0.002, respectively). Kaplan-Meier analysis confirmed substantial differences in in-hospital and ICU mortality across SHR quartiles. Conclusions SHR significantly predicts in-hospital and ICU mortality in critically ill CHD patients, indicating that higher SHR levels correlate with longer ICU stays and increased mortality. This underscores the potential of SHR as a prognostic marker for ICU CHD patients. |
| format | Article |
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| institution | Kabale University |
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| language | English |
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| spelling | doaj-art-1b96a743d4ae4f99b703262c4ce66ed02024-12-01T12:26:30ZengNature PortfolioScientific Reports2045-23222024-11-0114111210.1038/s41598-024-80763-xStress hyperglycemia ratio association with all-cause mortality in critically ill patients with coronary heart disease: an analysis of the MIMIC-IV databaseXiaofang Chen0Zewen Yang1Rui Shi2Xiaoyan Wang3Xuhua Li4Department of Cardiology, University Hospital, Zhejiang Normal UniversityDepartment of Cardiology, Yiwu Central HospitalDepartment of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen UniversityDepartment of Cardiology, University Hospital, Zhejiang Normal UniversityDepartment of Internal Medicine, University Hospital, Zhejiang Normal UniversityAbstract Background The stress hyperglycemia ratio (SHR) indicates relative hyperglycemia levels. Research on the impact of SHR on mortality in coronary heart disease (CHD) patients in intensive care is limited. This study explores the predictive accuracy of SHR for the prognosis of CHD patients in the ICU. Methods This study included 2,059 CHD patients from the American Medical Information Mart for Intensive Care (MIMIC-IV) database. SHR was determined using the formula: SHR = (admission glucose) (mmol/L) / (1.59 * HbA1c [%] – 2.59). Subjects were stratified into quartiles based on SHR levels to examine the correlation between SHR and in-hospital mortality. The restricted cubic splines and Cox proportional hazards models were employed to assess this association, while Kaplan-Meier survival analysis was executed to ascertain the mortality rates across the SHR quartiles. Results Among the 2059 participants (1358 men), the rates of in-hospital and ICU mortality were 8.5% and 5.25%, respectively. Analysis showed SHR as a significant predictor of increased risk for both in-hospital (HR,1.16, 95% CI: 1.02–1.32, P = 0.022) and ICU mortality (HR, 1.16, 95% CI: 1.01–1.35, P = 0.040) after adjustments. A J-shaped relationship was noted between SHR and mortality risks (p for non-linearity = 0.002, respectively). Kaplan-Meier analysis confirmed substantial differences in in-hospital and ICU mortality across SHR quartiles. Conclusions SHR significantly predicts in-hospital and ICU mortality in critically ill CHD patients, indicating that higher SHR levels correlate with longer ICU stays and increased mortality. This underscores the potential of SHR as a prognostic marker for ICU CHD patients.https://doi.org/10.1038/s41598-024-80763-xStress hyperglycemia ratioCoronary heart diseaseMortalityMIMIC-IV database |
| spellingShingle | Xiaofang Chen Zewen Yang Rui Shi Xiaoyan Wang Xuhua Li Stress hyperglycemia ratio association with all-cause mortality in critically ill patients with coronary heart disease: an analysis of the MIMIC-IV database Scientific Reports Stress hyperglycemia ratio Coronary heart disease Mortality MIMIC-IV database |
| title | Stress hyperglycemia ratio association with all-cause mortality in critically ill patients with coronary heart disease: an analysis of the MIMIC-IV database |
| title_full | Stress hyperglycemia ratio association with all-cause mortality in critically ill patients with coronary heart disease: an analysis of the MIMIC-IV database |
| title_fullStr | Stress hyperglycemia ratio association with all-cause mortality in critically ill patients with coronary heart disease: an analysis of the MIMIC-IV database |
| title_full_unstemmed | Stress hyperglycemia ratio association with all-cause mortality in critically ill patients with coronary heart disease: an analysis of the MIMIC-IV database |
| title_short | Stress hyperglycemia ratio association with all-cause mortality in critically ill patients with coronary heart disease: an analysis of the MIMIC-IV database |
| title_sort | stress hyperglycemia ratio association with all cause mortality in critically ill patients with coronary heart disease an analysis of the mimic iv database |
| topic | Stress hyperglycemia ratio Coronary heart disease Mortality MIMIC-IV database |
| url | https://doi.org/10.1038/s41598-024-80763-x |
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