Hengyang Key Laboratory of Hemorrhagic Cerebrovascular Disease, Department of Neurosurgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China.
Department of Neurosurgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.
Neurosurg Rev. 2024 Jul 12;47(1):315. doi: 10.1007/s10143-024-02549-z.
Previous research have demonstrated that the stress hyperglycemia ratio (SHR) accurately reflects acute hyperglycemic states and correlates with adverse outcomes. This study aims to explore the relationship between SHR and the prognosis of patients with aneurysmal subarachnoid hemorrhage (aSAH). Patients with aSAH were categorized into four groups based on SHR tertiles. Functional outcomes were evaluated at 12 months using the modified Rankin Scale (mRS), with scores ranging from 0 to 2 indicating a good outcome and 3-6 indicating a poor outcome. The associations between SHR and functional outcomes were analyzed using logistic regression models and restricted cubic spline analysis. A total of 127 patients exhibited poor functional outcomes. Following comprehensive adjustments, those in the highest SHR tertile had a significantly increased risk of poor prognosis compared to those in the lowest tertile (odds ratio [OR], 4.12; 95% confidence interval [CI]: 1.87-9.06). Moreover, each unit increase in SHR was associated with a 7.51-fold increase in the risk of poor prognosis (OR, 7.51; 95% CI: 3.19-17.70). Further analysis using restricted cubic spline confirmed a linear correlation between SHR and poor prognosis (P for nonlinearity = 0.609). Similar patterns were observed across all studied subgroups. Elevated SHR significantly correlates with poor functional prognosis at one year in patients with aSAH, independent of their diabetes status.
先前的研究表明，应激性高血糖比值（SHR）能够准确反映急性高血糖状态，并与不良结局相关。本研究旨在探讨 SHR 与颅内动脉瘤性蛛网膜下腔出血（aSAH）患者预后之间的关系。根据 SHR 三分位数将 aSAH 患者分为四组。采用改良 Rankin 量表（mRS）评估患者 12 个月时的功能结局，评分范围为 0-2 分表示预后良好，3-6 分表示预后不良。采用 logistic 回归模型和限制性立方样条分析来分析 SHR 与功能结局之间的关系。共有 127 例患者预后不良。经过全面调整后，与最低 SHR 三分位组相比，最高 SHR 三分位组的预后不良风险显著增加（比值比 [OR]，4.12；95%置信区间 [CI]：1.87-9.06）。此外，SHR 每增加一个单位，预后不良的风险就会增加 7.51 倍（OR，7.51；95%CI：3.19-17.70）。限制性立方样条进一步分析证实了 SHR 与预后不良之间存在线性关系（非线性 P 值=0.609）。在所有研究亚组中均观察到了相似的模式。在患有 aSAH 的患者中，即使不考虑糖尿病状态，升高的 SHR 与一年时的不良功能预后显著相关。
