Observational studyMedicine2025
Nonlinear association and predictive value of stress hyperglycemia ratio for 28-day in-hospital mortality in patients with acute hypoxemic respiratory failure.
Observational study in Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Association Between Fasting Blood Glucose and Myocardial Infarction Risk: Findings From the 2015-2018 NHANES Database and Mendelian Randomization Studies.Cardiology research and practice · 2026Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Stress hyperglycemia ratio (SHR), calculated as admission glucose divided by estimated average glucose from glycated hemoglobin, has emerged as a reliable biomarker of physiological stress. However, its prognostic role in acute hypoxemic respiratory failure (AHRF) - particularly the potential nonlinear relationship with short-term mortality - remains underexplored. This study aimed to evaluate the nonlinear association and predictive value of SHR for 28-day in-hospital mortality in AHRF patients. A retrospective cohort study was conducted using data from the medical information mart for intensive care version 3.1 database (2008-2019). Patients with AHRF (ICD-10 code: J9601) were included. Propensity score matching (1:1) was applied to balance baseline characteristics (sex, age, comorbidities) between high and low SHR groups. The primary outcome was 28-day in-hospital mortality. Restricted cubic spline models explored dose-response relationships. Kaplan-Meier survival curves, multivariable Cox regression, and subgroup analyses were used to assess associations. A total of 704 patients were included, with 614 successfully matched after propensity score matching. Restricted cubic spline analysis revealed a significant nonlinear association between SHR and 28-day mortality (P for overall = .002; P for nonlinearity = .002), with a critical inflection point at 1.215. Patients with SHR > 1.215 (high SHR group) had a significantly increased mortality risk (hazard ratio [HR] = 1.508, 95% confidence interval: 1.184-1.922; log-rank P < .001). Subgroup analyses confirmed consistent associations across most subgroups (e.g., age, sex, diabetes), with no significant interactions (all P > .05). Notably, the association was amplified in patients with prior myocardial infarction or congestive heart failure (interaction P = .021). SHR exhibits a nonlinear association with 28-day in-hospital mortality in AHRF patients, with a critical threshold at 1.215. It serves as a simple, accessible tool for early risk stratification, particularly in those with cardiovascular comorbidities.
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