ArticleCardiovascular diabetology2025
Stress hyperglycemia ratio and machine learning model for prediction of all-cause mortality in patients undergoing cardiac surgery.
Article in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Long-Term Mobile-Based Glycemic Intervention for Secondary Prevention in Patients With Diabetes Undergoing Surgical Revascularization: Multicenter Randomized Controlled Trial.Journal of medical Internet research · 2026Trial
- Nonlinear association between the stress hyperglycemia ratio and 180-day mortality in critically ill patients undergoing extracorporeal circulation during open heart surgery: a MIMIC-IV cohort study.Journal of cardiothoracic surgery · 2026Article
- Hemoglobin glycation index may contextualize the association between time-varying stress hyperglycemia ratio and mortality in critically ill patients with heart failure: a multicenter retrospective cohort study.Cardiovascular diabetology · 2026Article
- Prognostic value of stress hyperglycemia ratio, hemoglobin glycation index, and glycemic variability for postoperative atrial fibrillation: a machine learning-based prediction model.BMC medical informatics and decision making · 2026Article
- The stress hyperglycemia ratio as a novel risk marker for postoperative delirium after cardiac valve surgery.Scientific reports · 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
- A virtual reality-based multicomponent intervention program for preventing postoperative delirium in the intensive care unit for cardiac surgery patients: from evidence-based design to a pilot trial.Frontiers in medicine · 2026Article
- Explainable artificial intelligence in anesthesiology prediction models: bridging the gap from black-box algorithms to clinical decision support.Frontiers in medicine · 2026Review
- Nutritional-metabolic risk stratification for delirium in surgical critically ill patients: joint associations of the triglyceride-glucose index and stress hyperglycemia ratio.Frontiers in nutrition · 2026Article
- Tramadol use is associated with reduced 28-day mortality in ICU patients after cardiac surgery: a retrospective study based on the MIMIC-IV database.Frontiers in pharmacology · 2026Article
- Effect of stress-induced hyperglycaemia on clinical outcome in paitients with acute ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention.Frontiers in cardiovascular medicine · 2026Article
- Stress hyperglycemia ratio and long-term prognosis in patients with acute myocardial infarction undergoing percutaneous coronary intervention: evidence for an J-shaped association.Journal of geriatric cardiology : JGC · 2025Article
- Association between stress hyperglycemia ratio and all-cause mortality in patients with coronary heart disease.BMC cardiovascular disorders · 2025Article
- Relative hyperglycemia and new-onset atrial fibrillation after coronary artery bypass grafting: a focus on stress hyperglycemia ratio.BMC cardiovascular disorders · 2025Article
- Glycemic variability and postoperative mortality following cardiac surgery: evidence from a real-world ICU cohort.BMC cardiovascular disorders · 2025Observational
- Application of artificial intelligence in predicting the results of open-heart surgery: a scoping review.BMC medical informatics and decision making · 2025Article
- An ensemble machine learning-based risk stratification tool for 30-day mortality prediction in critically ill cardiovascular patients.Cardiovascular diabetology · 2025Article
- Weekend Effect and Predictors of Mortality for Patients Presenting to Emergency Department with COVID-19 Infection.Journal of personalized medicine · 2025Article
- Stress hyperglycemia ratio as a biomarker for early mortality risk stratification in cardiovascular disease: a propensity-matched analysis.Cardiovascular diabetology · 2025Observational
- Relationship between stress hyperglycemia ratio and the incidence of atrial fibrillation in patients after coronary artery bypass grafting: a retrospective study based on the MIMIC-IV database.Diabetology & metabolic syndrome · 2025Article
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8 authors.
Funding
Abstract
backgroundThe stress hyperglycemia ratio (SHR) was developed to reduce the effects of long-term chronic glycemic factors on stress hyperglycemia levels, which was associated with adverse clinical outcomes. This study aims to evaluate the relationship between the postoperative SHR index and all-cause mortality in patients undergoing cardiac surgery.
methodsData for this study were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients were categorized into four groups based on postoperative SHR index quartiles. The primary outcome was 30-day all-cause mortality, while the secondary outcomes included in-hospital, 90-day and 360-day all-cause mortality. The SHR index was analyzed using quartiles, and Kaplan-Meier curves were generated to compare outcomes across groups. Cox proportional hazards regression and restricted cubic splines (RCS) were employed to assess the relationship between the SHR index and the outcomes. LASSO regression was used for feature selection. Six machine learning algorithms were used to predict in-hospital all-cause mortality and were further extended to predict 360-day all-cause mortality. The SHapley Additive exPlanations method was used for visualizing model characteristics and individual case predictions.
resultsA total of 3,848 participants were included in the study, with a mean age of 68 ± 12 years and female participants comprised 30.6% (1,179). Higher postoperative SHR index levels were associated with an increased risk of in-hospital, 90-day and 360-day all-cause mortality as shown by Kaplan-Meier curves (log-rank P < 0.05). Cox regression analysis revealed that the highest postoperative SHR quartile was associated with a significantly higher risk of mortality at these time points (P < 0.05). RCS analysis demonstrated nonlinear relationships between the postoperative SHR index and all-cause mortality (P for nonlinear < 0.05). The Naive Bayes model achieves the highest area under the curve (AUC) for predicting both in-hospital mortality (0.7936) and 360-day all-cause mortality (0.7410).
conclusionIn patients undergoing cardiac surgery, higher postoperative SHR index levels were significantly associated with increased risk of in-hospital, 90-day and 360-day all-cause mortality. The SHR index may serve as a valid tool for assessing the severity after cardiac surgery and guiding treatment decisions.
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