ArticleBMC geriatrics2025
Association between stress hyperglycemia ratio and delirium risk in elderly surgical patients: a retrospective cohort study.
Article in BMC geriatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Association between stress hyperglycemia ratio and 72-hour delirium in critically ill patients: A retrospective cohort study from the MIMIC-IV database.Metabolism open · 2026Article
- Association of stress hyperglycemia ratio with malnutrition, sarcopenia, and frailty in older adults: a cross-sectional study.BMC geriatrics · 2026Article
- Association between stress hyperglycemia ratio and all-cause mortality in neurocritical patients.Scientific reports · 2026Article
- 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
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Authors and funding
7 authors.
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Abstract
backgroundThe stress hyperglycemia ratio (SHR) is an emerging glycemic marker in critical care, but its relationship with delirium in elderly surgical and trauma ICU patients remains unclear. This study explored the association between SHR and delirium to inform early identification strategies.
methodsWe performed a retrospective cohort study using the MIMIC-IV database, including 1,111 ICU patients aged ≥ 65 years with surgical or trauma admissions. SHR was calculated as the ratio of admission glucose to estimated average glucose (based on HbA1c) and categorized into quartiles. The primary outcome was ICU delirium, identified using the CAM-ICU tool; in-hospital mortality served as a secondary outcome. Multivariable logistic regression, restricted cubic spline (RCS) analysis, and propensity score matching (PSM) were used to assess associations and robustness. performance was evaluated via ROC curves.
resultsDelirium occurred in 31.1% of patients. Higher SHR was independently associated with greater odds of delirium (Q4 vs. Q1 adjusted OR = 2.79; 95% CI: 1.79-4.35), and this association remained after PSM. RCS analysis indicated a nonlinear relationship between SHR and delirium (P for nonlinearity = 0.0019), and a linear association with in-hospital mortality. SHR demonstrated limited discriminatory ability (AUCs: 0.625 for delirium, 0.654 for mortality).
conclusionSHR was independently associated with delirium in elderly surgical ICU patients. These findings support its potential role in delirium risk stratification, though prospective validation is needed.
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