Association between stress hyperglycemia ratio and short-term mortality in patients with Craniocerebral diseases: A retrospective cohort study

Abstract

Abstract Background the aim of the present study was to investigate the relationship between admission stress hyperglycemia ratio (SHR) and ICU and in-hospital mortality in patients with craniocerebral diseases and whether it was affected by pre-admission background glycemia compared to admission glucose. Methods In this retrospective study, the clinical data of 709 patients with craniocerebral diseases was drawn from the MIMIC-IV database. The study's main outcome was ICU and in-hospital mortality. All patients were further categorized by SHR tertiles. The associations between SHR and ICU and in-hospital mortality were assessed using multivariate logistic models, smooth curve fitting, and subgroup analysis. Results In multivariable analysis, SHR was positively associated with ICU and in-hospital mortality, with the OR increased stepwise from level 2 (ICU mortality, OR = 1.68, 95% CI: 0.74–3.83; in-hospital mortality, OR = 1.88, 95% CI: 0.99–3.57) to level 3 (ICU mortality, OR = 2.47, 95% CI: 1.12–5.45; in-hospital mortality, OR = 2.14, 95% CI: 1.13–4.04), referred to level 1. Based on smooth curve fitting, background blood glucose levels does not affect this relationship, which increased with SHR levels. In contrast, hyperglycemia at admission was only associated with clinical outcomes in patients without pre-admission background hyperglycemia. Conclusion SHR is an independent risk factor of ICU and in-hospital mortality in patients with craniocerebral diseases. Furthermore, compared to hyperglycemia on admission, background glycemia did not affect the relationship between SHR and mortality in the patients.