Association between stress hyperglycemia ratio and mortality in critically ill patients across different glucose metabolic status and diabetes mellitus subtypes.

Abstract

Introduction: No study has specifically investigated the correlation between stress hyperglycemia ratio (SHR) and mortality in critically ill patients across different glucose metabolic status and diabetes mellitus (DM) subtypes.

Material and methods: Analysis was conducted using the Medical Information Mart for Intensive Care-IV 2.2 database.

Result: In this study, a total of 73,181 intensive care unit (ICU) patients were included, among whom 33,683 critically ill patients were included in the final analysis. Logistic model analysis revealed that the SHR was associated with elevated mortality rates in the ICU and in-hospital among patients with type 2 diabetes mellitus (T2DM) and those in the ICU with different glucose metabolism status, particularly in individuals with prediabetes mellitus (Pre-DM) and normal glucose regulation (NGR). In the Cox proportional hazards model, SHR was linked to an increased risk of one-year mortality, particularly among critically ill patients with Pre-DM. Mediation analysis revealed that the high SHR could account for 14.0% and 11.3% of the increased risk of ICU death and in-hospital mortality associated with DM, respectively.

Conclusion: SHR is correlated with both short-term and long-term mortality in critically ill patients across various glucose metabolism status, particularly evident in those with NGR and Pre-DM. Moreover, SHR demonstrates an elevated risk of short-term and long-term mortality in critically ill patients with T2DM. Additionally, SHR plays a mediating role in the association between DM and mortality.