ArticleClinics (Sao Paulo, Brazil)2026
Predictive value of stress-induced hyperglycemia for 28-day all-cause mortality in ICU patients with sepsis: a MIMIC-IV-based retrospective cohort study.
Article in Clinics (Sao Paulo, Brazil), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis study explored the link between Stress-Induced Hyperglycemia (SIH) and 28-Day All-Cause Mortality (28D-ACM) in patients with sepsis, focusing on the predictive values of stress hyperglycemia ratios 1 and 2 (SHR1 and SHR2) and Glucose Gap (GG).
methodsThis retrospective cohort study included ICU patients with sepsis from the MIMIC-IV database. The relationships between the three SIH metrics and 28D-ACM risk were analyzed using multivariate Cox proportional hazards models, Kaplan-Meier curves, and restricted cubic spline analysis. The predictive performances of these metrics within a basic model were assessed using the Receiver Operating Characteristic (ROC) curve and Integrated Discrimination Improvement (IDI) index.
resultsThe study included 12,582 ICU patients with sepsis, with a 28D-ACM rate of 13.63%. In the fully adjusted model, SHR1, SHR2, and GG were independently associated with 28D-ACM risk, with Hazard Ratios (HR) and 95% Confidence Intervals (95% CIs) of 1.158 (1.029, 1.304), 1.18 (1.046, 1.332), and 1.133 (1.008, 1.275), respectively. Increased SIH metrics correlated positively with higher mortality risk (p
conclusionsSHR1, SHR2, and GG are significantly associated with 28D-ACM risk in ICU patients with sepsis. SHR1 showed statistical association with mortality and modest incremental value, but clinical utility for risk stratification is limited and needs external validation.
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