U−shaped association between the glycemic variability and prognosis in hemorrhagic stroke patients: a retrospective cohort study from the MIMIC-IV database
BackgroundElevated glycemic variability (GV) is commonly observed in intensive care unit (ICU) patients and has been associated with clinical outcomes. However, the relationship between GV and prognosis in ICU patients with hemorrhagic stroke (HS) remains unclear. This study aims to investigate the...
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Frontiers Media S.A.
2025-04-01
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| Series: | Frontiers in Endocrinology |
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| author | Yuchen Liu Houxin Fu Yue Wang Jingxuan Sun Rongting Zhang Yi Zhong Tianquan Yang Yong Han Yongjun Xiang Bin Yuan Ruxuan Zhou Min Chen Hangzhou Wang |
| author_facet | Yuchen Liu Houxin Fu Yue Wang Jingxuan Sun Rongting Zhang Yi Zhong Tianquan Yang Yong Han Yongjun Xiang Bin Yuan Ruxuan Zhou Min Chen Hangzhou Wang |
| author_sort | Yuchen Liu |
| collection | DOAJ |
| description | BackgroundElevated glycemic variability (GV) is commonly observed in intensive care unit (ICU) patients and has been associated with clinical outcomes. However, the relationship between GV and prognosis in ICU patients with hemorrhagic stroke (HS) remains unclear. This study aims to investigate the association between GV and short- and long-term all-cause mortality.MethodsClinical data for hemorrhagic stroke (HS) patients were obtained from the MIMIC-IV 3.1 database. GV was quantified using the coefficient of variation (CV), calculated as the ratio of the standard deviation to the mean blood glucose level. The association between GV and clinical outcomes was analyzed using Cox proportional hazards regression models. Additionally, restricted cubic spline (RCS) curves were employed to examine the nonlinear relationship between GV and short- and long-term all-cause mortality.ResultsA total of 2,240 ICU patients with HS were included in this study. In fully adjusted models, RCS analyses revealed a U-shaped association between the CV and both short- and long-term all-cause mortality (P for nonlinearity < 0.001 for all outcomes). Two-piecewise Cox regression models were subsequently applied to identify CV thresholds. The thresholds for all-cause mortality in ICU, during hospitalization, and at 30, 90, and 180 days were determined to be 0.14, 0.16, 0.155, 0.14, and 0.14, respectively. These findings were consistent in sensitivity and subgroup analyses.ConclusionsIn HS patients, higher GV is associated with an increased risk of both short- and long-term all-cause mortality. Our findings suggest that stabilizing GV may improve the prognosis of HS patients. |
| format | Article |
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| institution | DOAJ |
| issn | 1664-2392 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Endocrinology |
| spelling | doaj-art-e8a58bbbd5714fe3ab71fc812cf296ff2025-08-20T03:03:06ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-04-011610.3389/fendo.2025.15461641546164U−shaped association between the glycemic variability and prognosis in hemorrhagic stroke patients: a retrospective cohort study from the MIMIC-IV databaseYuchen Liu0Houxin Fu1Yue Wang2Jingxuan Sun3Rongting Zhang4Yi Zhong5Tianquan Yang6Yong Han7Yongjun Xiang8Bin Yuan9Ruxuan Zhou10Min Chen11Hangzhou Wang12Department of Neurosurgery, Children’s Hospital of Soochow University, Suzhou, Jiangsu, ChinaDepartment of Pediatric Hematology and Oncology, Children’s Hospital of Soochow University, Suzhou, Jiangsu, ChinaInstitute of Pediatric Research, Children’s Hospital of Soochow University, Suzhou, Jiangsu, ChinaDepartment of Neurosurgery, Children’s Hospital of Soochow University, Suzhou, Jiangsu, ChinaDepartment of Neurosurgery, Children’s Hospital of Soochow University, Suzhou, Jiangsu, ChinaDepartment of Neurosurgery, Children’s Hospital of Soochow University, Suzhou, Jiangsu, ChinaDepartment of Neurosurgery, Children’s Hospital of Soochow University, Suzhou, Jiangsu, ChinaDepartment of Neurosurgery, Children’s Hospital of Soochow University, Suzhou, Jiangsu, ChinaDepartment of Neurosurgery, Children’s Hospital of Soochow University, Suzhou, Jiangsu, ChinaDepartment of Neurosurgery, Children’s Hospital of Soochow University, Suzhou, Jiangsu, ChinaDepartment of Neurosurgery, Children’s Hospital of Soochow University, Suzhou, Jiangsu, ChinaDepartment of Neurosurgery, Children’s Hospital of Soochow University, Suzhou, Jiangsu, ChinaDepartment of Neurosurgery, Children’s Hospital of Soochow University, Suzhou, Jiangsu, ChinaBackgroundElevated glycemic variability (GV) is commonly observed in intensive care unit (ICU) patients and has been associated with clinical outcomes. However, the relationship between GV and prognosis in ICU patients with hemorrhagic stroke (HS) remains unclear. This study aims to investigate the association between GV and short- and long-term all-cause mortality.MethodsClinical data for hemorrhagic stroke (HS) patients were obtained from the MIMIC-IV 3.1 database. GV was quantified using the coefficient of variation (CV), calculated as the ratio of the standard deviation to the mean blood glucose level. The association between GV and clinical outcomes was analyzed using Cox proportional hazards regression models. Additionally, restricted cubic spline (RCS) curves were employed to examine the nonlinear relationship between GV and short- and long-term all-cause mortality.ResultsA total of 2,240 ICU patients with HS were included in this study. In fully adjusted models, RCS analyses revealed a U-shaped association between the CV and both short- and long-term all-cause mortality (P for nonlinearity < 0.001 for all outcomes). Two-piecewise Cox regression models were subsequently applied to identify CV thresholds. The thresholds for all-cause mortality in ICU, during hospitalization, and at 30, 90, and 180 days were determined to be 0.14, 0.16, 0.155, 0.14, and 0.14, respectively. These findings were consistent in sensitivity and subgroup analyses.ConclusionsIn HS patients, higher GV is associated with an increased risk of both short- and long-term all-cause mortality. Our findings suggest that stabilizing GV may improve the prognosis of HS patients.https://www.frontiersin.org/articles/10.3389/fendo.2025.1546164/fullglycemic variabilityhemorrhagic strokeMIMIC-IV databaseprognosisintensive care unit (ICU) |
| spellingShingle | Yuchen Liu Houxin Fu Yue Wang Jingxuan Sun Rongting Zhang Yi Zhong Tianquan Yang Yong Han Yongjun Xiang Bin Yuan Ruxuan Zhou Min Chen Hangzhou Wang U−shaped association between the glycemic variability and prognosis in hemorrhagic stroke patients: a retrospective cohort study from the MIMIC-IV database Frontiers in Endocrinology glycemic variability hemorrhagic stroke MIMIC-IV database prognosis intensive care unit (ICU) |
| title | U−shaped association between the glycemic variability and prognosis in hemorrhagic stroke patients: a retrospective cohort study from the MIMIC-IV database |
| title_full | U−shaped association between the glycemic variability and prognosis in hemorrhagic stroke patients: a retrospective cohort study from the MIMIC-IV database |
| title_fullStr | U−shaped association between the glycemic variability and prognosis in hemorrhagic stroke patients: a retrospective cohort study from the MIMIC-IV database |
| title_full_unstemmed | U−shaped association between the glycemic variability and prognosis in hemorrhagic stroke patients: a retrospective cohort study from the MIMIC-IV database |
| title_short | U−shaped association between the glycemic variability and prognosis in hemorrhagic stroke patients: a retrospective cohort study from the MIMIC-IV database |
| title_sort | u shaped association between the glycemic variability and prognosis in hemorrhagic stroke patients a retrospective cohort study from the mimic iv database |
| topic | glycemic variability hemorrhagic stroke MIMIC-IV database prognosis intensive care unit (ICU) |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2025.1546164/full |
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