SynthesisFrontiers in medicine2026
Stress hyperglycemia ratio and short-term mortality in critically ill patients with respiratory diseases: a systematic review and dose-response meta-analysis.
Synthesis in Frontiers in medicine, 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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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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4 authors.
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Abstract
Objective: To systematically evaluate the association between the HbA1c-adjusted stress hyperglycemia ratio (SHR) and short-term mortality in patients with severe respiratory diseases and characterize its linear and nonlinear dose-response relationships. Methods: PubMed, Embase, China National Knowledge Infrastructure, Wanfang, VIP, and the Chinese Biomedical Literature Database were searched for observational studies evaluating SHR and short-term mortality, including in-hospital, intensive care unit (ICU), 28-day, or 30-day mortality. Odds ratios (ORs) and hazard ratios (HRs) were pooled separately using random-effects models. Sensitivity analyses, linear dose-response analyses, restricted cubic spline analyses, and exploratory analyses of low and high SHR were performed. Results: Eleven studies were included. Four studies contributed to the OR-based primary meta-analysis. Short-term mortality tended to be higher in the highest SHR category than in the study-specific reference category, but the association was not statistically significant (OR = 2.72, 95% CI: 0.74-9.93, Conclusions: Current evidence suggests that higher SHR is associated with increased short-term mortality risk in patients with severe respiratory diseases. HR-based evidence was more consistent and supported a positive linear dose-response relationship. OR-based findings pointed in the same direction but showed substantial heterogeneity and did not reach statistical significance. The available evidence is insufficient to confirm a clear nonlinear pattern. Given the limited number of studies and wide confidence intervals, the apparent increase in risk at both low and high SHR levels should be interpreted as exploratory and does not yet support a stable U-shaped or J-shaped dose-response pattern. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261418259, PROSPERO CRD420261418259.
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