Association of stress hyperglycemia ratio trajectories and cumulative stress hyperglycemia burden with in-hospital mortality in ICU patients with heart failure: a retrospective cohort study

Association of stress hyperglycemia ratio trajectories and cumulative stress hyperglycemia burden with in-hospital mortality in ICU patients with heart failure: a retrospective cohort study. Download PDF Abstract Heart failure (HF) is a major global health concern, and traditional prognostic markers incompletely reflect acute stress status. Although the stress hyperglycemia ratio (SHR) better assesses acute glycemic burden and correlates with adverse outcomes in critically ill HF patients, previous studies focused on single-time-point measurements, ignoring its dynamic trajectories and cumulative stress hyperglycemia ratio (CumSHR) burden.

This study thus investigated their prognostic significance in intensive care unit (ICU) patients with HF using the Medical Information Mart for Intensive Care (MIMIC) database. This retrospective cohort study used data from the MIMIC-IV database, with external validation performed in the MIMIC-III database. Adult ICU patients diagnosed with HF were included.

Latent class growth modeling (LCGM) was applied to identify SHR trajectories during the first 6 days after ICU admission. CumSHR was calculated using the trapezoidal rule to reflect cumulative glycemic burden. Multivariable regression, Kaplan–Meier analysis, and restricted cubic spline (RCS) models were used to evaluate the association between SHR patterns and mortality outcomes.

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