ArticleCardiovascular diabetology2024
Association between stress hyperglycemia ratio and postoperative major adverse cardiovascular and cerebrovascular events in noncardiac surgeries: a large perioperative cohort study.
Article in Cardiovascular diabetology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association between stress hyperglycemia and pneumonia in patients with stroke: a systematic review and meta-analysis.BMC pulmonary medicine · 2025Pooled it
- Association between the preoperative stress hyperglycemia ratio and postoperative delirium in older adults undergoing non-cardiac surgery: a retrospective cohort study.European geriatric medicine · 2026Article
- Integration of stress hyperglycemia ratio and c-reactive protein level improves postoperative acute kidney injury risk stratification after noncardiac surgery: A nested case-control study.Pakistan journal of medical sciences · 2026Article
- Relation of the stress hyperglycaemia ratio to residual risk in anticoagulated patients with atrial fibrillation: A report from the prospective Murcia AF Project III cohort.Diabetes, obesity & metabolism · 2026Article
- Combined assessment with stress hyperglycemia ratio and time in range: Associations with twenty-eight-day mortality in surgical intensive care unit patients.World journal of diabetes · 2026Article
- Elevated stress hyperglycemia ratio predicts intensive care unit admission after surgery for gastrointestinal tumors: an INSPIRE database analysis.Frontiers in medicine · 2026Article
- The revised cardiac risk index and 90-day mortality after non-cardiac surgery: a retrospective cohort study.Frontiers in cardiovascular medicine · 2026Article
- Relationship between stress hyperglycemia ratio and gastrointestinal bleeding and mortality after coronary artery bypass grafting: a multicenter cohort study.Frontiers in cardiovascular medicine · 2026Article
- Association between stress hyperglycemia ratio and all-cause mortality in patients with acute kidney injury: a retrospective analysis of the MIMIC-IV database using machine learning.BMC nephrology · 2025Article
- Accelerated biological aging mediates the associations of stress hyperglycemia ratio (SHR) with mortality in type 2 diabetes and obesity (diabesity).Cardiovascular diabetology · 2025Article
- Stress hyperglycemia ratio as a biomarker for early mortality risk stratification in cardiovascular disease: a propensity-matched analysis.Cardiovascular diabetology · 2025Observational
- Combined assessment of stress hyperglycemia ratio and glycemic variability to predict all-cause mortality in critically ill patients with atherosclerotic cardiovascular diseases across different glucose metabolic states: an observational cohort study with machine learning.Cardiovascular diabetology · 2025Observational
- Association of stress hyperglycemia ratio with short-term and long-term prognosis in patients undergoing coronary artery bypass grafting across different glucose metabolism states: a large-scale cohort study.Cardiovascular diabetology · 2025Observational
- Assessment of stress hyperglycemia ratio to predict all-cause mortality in patients with critical cerebrovascular disease: a retrospective cohort study from the MIMIC-IV database.Cardiovascular diabetology · 2025Article
- Relationship between stress hyperglycemia ratio and progression of non target coronary lesions: a retrospective cohort study.Diabetology & metabolic syndrome · 2025Article
- Distinct patterns of association between the hemoglobin glycation index, the stress-hyperglycemia ratio, and the risk of new-onset atrial fibrillation in critically ill patients.Frontiers in endocrinology · 2025Article
- Association between the postoperative glycemic variability and mortality after craniotomy: a retrospective cohort study and development of a mortality prediction model.Frontiers in endocrinology · 2025Article
- Association and predictive ability between significant perioperative cardiovascular adverse events and stress glucose rise in patients undergoing non-cardiac surgery.Cardiovascular diabetology · 2024Article
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Abstract
backgroundThere has been a concerning rise in the incidence of major adverse cardiovascular and cerebrovascular events (MACCE) following noncardiac surgeries (NCS), significantly impacting surgical outcomes and patient prognosis. Glucose metabolism abnormalities induced by stress response under acute medical conditions may be a risk factor for postoperative MACCE. This study aims to explore the association between stress hyperglycemia ratio (SHR) and postoperative MACCE in patients undergoing general anesthesia for NCS.
methodsThere were 12,899 patients in this perioperative cohort study. The primary outcome was MACCE within 30 days postoperatively, defined as angina, acute myocardial infarction, cardiac arrest, arrhythmia, heart failure, stroke, or in-hospital all-cause mortality. Kaplan-Meier curves visualized the cumulative incidence of MACCE. Cox proportional hazard models were utilized to assess the association between the risk of MACCE and different SHR groups. Restricted cubic spline analyses were conducted to explore potential nonlinear relationships. Additionally, exploratory subgroup analyses and sensitivity analyses were performed.
resultsA total of 592 (4.59%) participants experienced MACCE within 30 days after surgery, and 1,045 (8.10%) within 90 days. After adjusting for confounding factors, compared to the SHR T2 group, the risk of MACCE within 30 days after surgery increased by 1.34 times (95% CI 1.08-1.66) in the T3 group and by 1.35 times (95% CI 1.08-1.68) in the T1 group respectively. In the non-diabetes group, the risk of MACCE within 30 days after surgery increased by 1.60 times (95% CI 1.21-2.12) in the T3 group and by 1.61 times (95% CI 1.21-2.14) in the T1 group respectively, while no statistically significant increase in risk was observed in the diabetes group. Similar results were observed within 90 days after surgery in the non-diabetes group. Additionally, a statistically significant U-shaped nonlinear relationship was observed in the non-diabetes group (30 days: P for nonlinear = 0.010; 90 days: P for nonlinear = 0.008).
conclusionIn this large perioperative cohort study, we observed that both higher and lower SHR were associated with an increased risk of MACCE within 30 and 90 days after NCS, especially in patients without diabetes. These findings suggest that SHR potentially plays a key role in stratifying cardiovascular and cerebrovascular risk after NCS.
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