ArticleBMC infectious diseases2024
The association between stress hyperglycemia ratio and clinical outcomes in patients with sepsis-associated acute kidney injury: a secondary analysis of the MIMIC-IV database.
Article in BMC infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Predictive performance of stress hyperglycemia ratio for poor prognosis in critically ill patients: a systematic review and dose-response meta-analysis.European journal of medical research · 2025Pooled it
- Stress hyperglycemia ratio in risk stratification and treatment optimization for patients on invasive mechanical ventilation: a secondary analysis of the MIMIC-IV database.BMC infectious diseases · 2026Article
- Relationship of endothelial activation and stress index on concurrent acute kidney injury in patients with heart failure during intensive care unit: a competing risk model analysis.BMC cardiovascular disorders · 2025Observational
- 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
- Correlation between stress hyperglycemic ratio and all-cause mortality in diabetic patients with heart failure.BMC endocrine disorders · 2025Article
- The Stress Hyperglycemia Ratio as a Predictor of Clinical Outcomes in Acute Pancreatitis: A Retrospective Cohort Study.Journal of clinical medicine · 2025Article
- The association of albumin-corrected anion gap and acute kidney injury in heart failure patients: a competing risk model analysis.BMC cardiovascular disorders · 2025Article
- Stress hyperglycemia ratio: a novel prognostic marker in chronic kidney disease.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
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Abstract
backgroundThe stress hyperglycemia ratio (SHR) is associated with poor outcomes in critically ill patients. However, the relationship between SHR and mortality in patients with sepsis-associated acute kidney injury (SA-AKI) remains unclear.
methodsThe data of patients with SA-AKI, identified based on the KDIGO criteria, were retrospectively collected from the Beth Israel Deaconess Medical Center between 2008 and 2019. SHR was calculated as follows: (glycemia [mmol/L]) / (1.59 × HbA1c [%] - 2.59). Primary outcomes were 30-day and 1-year mortality. The cumulative incidence of all-cause mortality was assessed using Kaplan-Meier survival analysis. Multivariable-adjusted logistic and Cox models and restricted cubic spline curves were used to analyze the correlation between SHR and all-cause mortality. Post-hoc subgroup analysis was performed to compare the effects of SHR across different subgroups.
results1161 patients with SA-AKI were identified and categorized into four SHR quartiles as follows: Q1 (0.26, 0.90), Q2 (0.91, 1.08), Q3 (1.09, 1.30), and Q4 (1.31, 5.42). The median age of patients was 69 years, with 42.7% of the patients being women and 20.2% of the patients having chronic kidney disease. The 30-day and 1-year mortality were 22.1% and 35.0% respectively. Kaplan-Meier survival analysis indicated a gradual decrease in survival probability with increasing SHR quartiles. An increased SHR exhibited a strong correlation with 30-day mortality (hazard ratio [HR], 1.50; 95% confidence interval [CI], 1.18-1.90; P < 0.001) and 1-year mortality (HR, 1.32; 95% CI, 1.06-1.65; P = 0.014). SHR has a nonlinear relationship with 1-year mortality but not with 30-day mortality (P-nonlinear = 0.048 and 0.114, respectively). The results of subgroup analysis were mostly consistent with these findings.
conclusionAn increased SHR is independently associated with 30-day and 1-year mortality in patients with SA-AKI. Therefore, SHR may serve as an effective tool for risk stratification in patients with SA-AKI.
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