Ge Tingai, Hu Jingjing, Zhou Yidan
Department of Emergency Medicine, Hangzhou Third People's Hospital, Hangzhou, China.
Front Cardiovasc Med. 2024 Nov 21;11:1463861. doi: 10.3389/fcvm.2024.1463861. eCollection 2024.
It's recognized that stress hyperglycemia ratio (SHR) is considered a significant indicator of poor prognosis in many diseases. However, its role in critically ill patients with acute heart failure (acute HF) remains underexplored.
We conducted a retrospective cohort study on patients with acute HF included in the Medical Information Mart for Intensive Care IV (MIMIC-IV) version 2.2 database. A restricted cubic spline (RCS) regression analysis was used to explore the relationship between SHR and the risk of all-cause mortality in these patients. Subsequently, a Cox regression model was used to evaluate the relationship between SHR and mortality in acute HF patients.
A total of 1,644 acute HF patients were included in the study and divided into two groups: the low SHR group (SHR < 1.06, = 823) and the high SHR group (SHR ≥ 1.06, = 821). In our study, the 30-day, 90-day, 180-day, and 365-day mortality rates for acute HF were 7.0%, 12%, 15%, and 19%, respectively, with higher mortality rates observed in the high SHR group compared to the low SHR group. SHR levels showed a linear relationship with all-cause mortality. Furthermore, SHR as a continuous variable shows a significant positive correlation with 30-day (HR = 2.31, 95% CI: 1.58-3.39), 90-day (HR = 1.81, 95% CI: 1.31-2.52), 180-day (HR = 1.57, 95% CI: 1.16-2.12), and 365-day (HR = 1.41, 95% CI: 1.07-1.85) all-cause mortality. After categorization, high SHR remains associated with increased 30-day (HR = 2.4, 95% CI: 1.59-3.61), 90-day (HR = 1.76, 95% CI: 1.31-2.36), 180-day (HR = 1.51, 95% CI: 1.16-1.95), and 365-day (HR = 1.38, 95% CI: 1.09-1.73) all-cause mortality.
Our findings indicate that high SHR is an independent predictor of poor short- and long-term prognosis in acute HF patients. Understanding the impact of SHR on mortality in acute HF is crucial as it can assist clinicians in identifying high-risk patients and adjusting treatment strategies accordingly.
应激性高血糖比率（SHR）被认为是许多疾病预后不良的重要指标。然而，其在急性心力衰竭（急性HF）重症患者中的作用仍未得到充分研究。
我们对重症监护医学信息数据库第四版（MIMIC-IV）2.2版中纳入的急性HF患者进行了一项回顾性队列研究。使用受限立方样条（RCS）回归分析来探索这些患者的SHR与全因死亡率风险之间的关系。随后，使用Cox回归模型评估急性HF患者中SHR与死亡率之间的关系。
本研究共纳入1644例急性HF患者，分为两组：低SHR组（SHR＜1.06，n = 823）和高SHR组（SHR≥1.06，n = 821）。在我们的研究中，急性HF患者的30天、90天、180天和365天死亡率分别为7.0%、12%、15%和19%，高SHR组的死亡率高于低SHR组。SHR水平与全因死亡率呈线性关系。此外，SHR作为连续变量与30天（HR = 2.31，95%CI：1.58 - 3.39）、90天（HR = 1.81，95%CI：1.31 - 2.52）、180天（HR = 1.57，95%CI：1.16 - 2.12）和365天（HR = 1.41，95%CI：1.07 - 1.85）全因死亡率显著正相关。分类后，高SHR仍与30天（HR = 2.4，95%CI：1.59 - 3.61）、90天（HR = 1.76，95%CI：1.31 - 2.36）、180天（HR = 1.51，95%CI：1.16 - 1.95）和365天（HR = 1.38，95%CI：1.09 - 1.73）全因死亡率增加相关。
我们的研究结果表明，高SHR是急性HF患者短期和长期预后不良的独立预测指标。了解SHR对急性HF死亡率的影响至关重要，因为它可以帮助临床医生识别高危患者并相应地调整治疗策略。
