ArticleCNS neuroscience & therapeutics2022
Stress hyperglycemia is associated with in-hospital mortality in patients with diabetes and acute ischemic stroke.
Article in CNS neuroscience & therapeutics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 3 of them syntheses that pooled it.
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Who cites it
62 citing papers in PubMed, 3 syntheses or guidelines pooled it, 103 citations in OpenAlex.
- Relationship between stress hyperglycaemic ratio (SHR) and critical illness: a systematic review.Cardiovascular diabetology · 2025Pooled it
- Stress hyperglycemia and risk of adverse outcomes in patients with acute ischemic stroke: a systematic review and dose-response meta-analysis of cohort studies.Frontiers in neurology · 2023Pooled it
- Association of the stress hyperglycemia ratio and clinical outcomes in patients with stroke: A systematic review and meta-analysis.Frontiers in neurology · 2022Pooled it
- Predictive value of stress-induced hyperglycemia for 28-day all-cause mortality in ICU patients with sepsis: a MIMIC-IV-based retrospective cohort study.Clinics (Sao Paulo, Brazil) · 2026Article
- Correlation between SHR and 28-day all-cause mortality risk in patients with spontaneous intracerebral hemorrhage.BMC neurology · 2026Article
- Cumulative stress hyperglycemia ratio exposure and dynamic trajectories reveal prognostic determinants of acute hyperlipidemic pancreatitis: an 5-year cohort study.Lipids in health and disease · 2026Article
- Stress Hyperglycemia Ratio and the Risk of Sepsis in Patients With Heart Failure: Retrospective Cohort Study From Medical Information Mart for Intensive Care-IV.JMIR medical informatics · 2026Article
- Impact of Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitor on Immune-Inflammatory Responses in the Acute Phase of Ischemic Stroke.Journal of inflammation research · 2026Article
- Article
- Correlation between EASIX and short- and long-term prognosis of patients with ischemic stroke.BMC neurology · 2025Article
- Stress hyperglycemia ratio as an independent predictor of acute kidney injury in critically ill patients with acute myocardial infarction: a retrospective U.S. cohort study.Renal failure · 2025Article
- Joint impact of stress hyperglycaemic ratio and glycaemic variability in patients with ischaemic stroke and machine learning for mortality prediction.BMC neurology · 2025Article
- The Association Between Stress Hyperglycemia Ratio and Short-Term Outcomes After Successful Recanalization by Mechanical Thrombectomy in Acute Ischemic Stroke Patients.Brain and behavior · 2025Article
- Association of stress hyperglycemia ratio with clinical outcomes in patients with chronic obstructive pulmonary disease and type 2 diabetes mellitus in intensive care units: a retrospective study.Journal of thoracic disease · 2025Article
- Correlation between stress hyperglycemic ratio and all-cause mortality in diabetic patients with heart failure.BMC endocrine disorders · 2025Article
- Autonomic dysfunction after stroke: an overview of recent clinical evidence and perspectives on therapeutic management.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025Review
- Review
- Stress Hyperglycemia as a Prognostic Indicator of the Clinical Outcomes in Patients with Stroke: A Comprehensive Literature Review.Biomedicines · 2025Review
- Association between stress hyperglycemia ratio (SHR) and the risk of acute kidney injury in patients with chronic kidney disease: analysis of the MIMIC-IV database.BMC nephrology · 2025Article
- Risk analysis and mediation analysis of stress hyperglycemia ratio and all-cause mortality in patients with acute kidney injury.Diabetology & metabolic syndrome · 2025Article
2 more citing papers are in PubMed but not listed here.
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectiveStress hyperglycemia may occur in diabetic patients with acute severe cerebrovascular disease, but the results regarding its association with stroke outcomes are conflicting. This study aimed to examine the association between stress-induced hyperglycemia and the occurrence of in-hospital death in patients with diabetes and acute ischemic stroke. RESEARCH DESIGN AND
methodsAll data were from the Chinese Stroke Center Alliance (CSCA) database and were collected between 2016 and 2018 from >300 centers across China. Patients' demographics, clinical presentation, and laboratory data were extracted from the database. The primary endpoint was in-hospital death. The ratio of fasting blood glucose (FBG) to HbA1c was calculated, that is, the stress-induced hyperglycemia ratio (SHR), to determine stress hyperglycemia following acute ischemic stroke.
resultsA total of 168,381 patients were included. The mean age was 66.2 ± 10.7, and 77,688 (43.0%) patients were female. The patients were divided into two groups: survivors (n = 167,499) and non-survivors (n = 882), as well as into four groups according to their SHR quartiles (n = 42,090-42,099/quartile). There were 109 (0.26%), 142 (0.34%), 196 (0.47%), and 435 (1.03%) patients who died in the Q1, Q2, Q3, and Q4 quartiles, respectively. Compared with Q1 patients, the death risk was higher in Q4 patients (odds ratio (OR) = 4.02) (adjusted OR = 1.80, 95% confidence interval [CI] = 1.10-2.92, p = 0.018 after adjustment for traditional cardiovascular risk factors). The ROC analyses showed that SHR (AUC = 0.667, 95% CI: 0.647-0.686) had a better predictive value for mortality than that of fasting blood glucose (AUC = 0.633, 95% CI: 0.613-0.652) and HbA1c (AUC = 0.523, 95% CI: 0.504-0.543).
conclusionsThe SHR may serve as an accessory parameter for the prognosis of patients with diabetes after acute ischemic stroke. Hyperglycemia in stroke patients with diabetes mellitus is associated with a higher risk of in-hospital death.
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