Association between stress-induced hyperglycemia ratio and sepsis risk in patients admitted to ICU.

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in Clinical and Experimental Medicine Pub Date : 2025-01-10 DOI:10.17219/acem/194503

Yanjun Xu, Jing Yang, Zexing Jiang, Peng Liu, Xudong Wang

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引用次数: 0

Abstract

Background: Sepsis is a life-threatening condition characterized by a dysregulated host immune response to infection. Currently, stress hyperglycemia is frequently associated with an unfavorable prognosis in cardiovascular and cerebrovascular disease. During sepsis, the progression of the immune response and inflammation often leads to aberrant metabolic indicators. However, the association between the stress-induced hyperglycemia ratio (SHR) and sepsis in patients admitted to the intensive care unit (ICU) remains uncertain.

Objectives: This study aimed to explore the potential correlation between SHR and sepsis.

Material and methods: In this retrospective cohort study, data were obtained from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. Patients with recorded glucose and glycosylated HbA1c levels within 24-h ICU admission were identified. The endpoints of the follow-up period were the occurrence of sepsis during ICU stay or ICU discharge. After adjustment for factors including demographics, vital signs and biochemical indicators, the univariate and multivariate logistic regression model was employed to examine the relationship between SHR, baseline blood glucose levels and the risk of sepsis. The associations were further explored in subgroups based on age, gender and presence/absence of type 2 diabetes.

Results: Of the total 2,161 patients, with the average age of 64.96 ±16.84 years, 205 (9.49%) had sepsis. After adjustment or confounders, high SHR levels were associated with the risk of sepsis odds ratio (OR) = 1.53, 95% confidence interval (95% CI): 1.07-2.17). Similar results were found in patients aged ≥65 years (OR = 1.91, 95% CI: 1.16-3.17), in men (OR = 1.64, 95% CI: 1.02-2.63) and patients without type 2 diabetes history (OR = 1.58, 95% CI: 1.01-2.48). The baseline blood glucose level did not exhibit a significant association with the risk of sepsis.

Conclusions: Elevated SHR levels were correlated with sepsis. Bedside monitoring of SHR may be a valuable tool for clinicians to identify patients at high risk of sepsis, and be beneficial to promptly implement clinical interventions.

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来源期刊

Advances in Clinical and Experimental Medicine MEDICINE, RESEARCH & EXPERIMENTAL-

CiteScore

3.70

自引率

4.80%

发文量

153

审稿时长

6-12 weeks

期刊介绍： Advances in Clinical and Experimental Medicine has been published by the Wroclaw Medical University since 1992. Establishing the medical journal was the idea of Prof. Bogumił Halawa, Chair of the Department of Cardiology, and was fully supported by the Rector of Wroclaw Medical University, Prof. Zbigniew Knapik. Prof. Halawa was also the first editor-in-chief, between 1992-1997. The journal, then entitled "Postępy Medycyny Klinicznej i Doświadczalnej", appeared quarterly. Prof. Leszek Paradowski was editor-in-chief from 1997-1999. In 1998 he initiated alterations in the profile and cover design of the journal which were accepted by the Editorial Board. The title was changed to Advances in Clinical and Experimental Medicine. Articles in English were welcomed. A number of outstanding representatives of medical science from Poland and abroad were invited to participate in the newly established International Editorial Staff. Prof. Antonina Harłozińska-Szmyrka was editor-in-chief in years 2000-2005, in years 2006-2007 once again prof. Leszek Paradowski and prof. Maria Podolak-Dawidziak was editor-in-chief in years 2008-2016. Since 2017 the editor-in chief is prof. Maciej Bagłaj. Since July 2005, original papers have been published only in English. Case reports are no longer accepted. The manuscripts are reviewed by two independent reviewers and a statistical reviewer, and English texts are proofread by a native speaker. The journal has been indexed in several databases: Scopus, Ulrich’sTM International Periodicals Directory, Index Copernicus and since 2007 in Thomson Reuters databases: Science Citation Index Expanded i Journal Citation Reports/Science Edition. In 2010 the journal obtained Impact Factor which is now 1.179 pts. Articles published in the journal are worth 15 points among Polish journals according to the Polish Committee for Scientific Research and 169.43 points according to the Index Copernicus. Since November 7, 2012, Advances in Clinical and Experimental Medicine has been indexed and included in National Library of Medicine’s MEDLINE database. English abstracts printed in the journal are included and searchable using PubMed http://www.ncbi.nlm.nih.gov/pubmed.