Association between stress hyperglycemia ratio and mortality in patients with heart failure complicated by sepsis

被引:0
|
作者
Song, Lijun [1 ,2 ]
Ying, Jianjun [3 ]
Li, Min [1 ,2 ]
Weng, Chenxi [1 ,2 ]
Jia, Shengwei [1 ,2 ]
Ying, Lan [4 ]
Li, Zhiyu [5 ]
机构
[1] Zhejiang Univ, Affiliated Hosp 4, Sch Med, Dept Crit Care Med, Yiwu 322000, Peoples R China
[2] Zhejiang Univ, Int Inst Med, Int Sch Med, Yiwu 322000, Peoples R China
[3] Yiwu Tradit Chinese Med Hosp, Dept Gen Med, Yiwu 322000, Zhejiang, Peoples R China
[4] Zhejiang Univ, Sch Med, Affiliated Hosp 2, Dept Emergency Med, Hangzhou 310000, Zhejiang, Peoples R China
[5] Nanjing Med Univ, Wuxi Peoples Hosp, Wuxi Med Ctr, Nanjing 214000, Peoples R China
来源
SCIENTIFIC REPORTS | 2024年 / 14卷 / 01期
关键词
Stress hyperglycemia ratio; Heart failure; Sepsis; Mortality; MIMIC-IV;
D O I
10.1038/s41598-024-82890-x
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Individuals afflicted with heart failure complicated by sepsis often experience a surge in blood glucose levels, a phenomenon known as stress hyperglycemia. However, the correlation between this condition and overall mortality remains unclear. 869 individuals with heart failure complicated by sepsis were identified from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database and categorized into five cohorts based on their stress hyperglycemia ratio (SHR). The primary endpoints evaluated were mortality within the intensive care unit (ICU), all-cause mortality within 28 days, and all-cause mortality during hospitalization. Cox proportional hazards regression and restricted cubic spline analyses were employed to unravel the association between SHR and mortality. The ICU mortality, in-hospital mortality, and 28-day all-cause mortality were 10.01%, 13.69%, and 16.46%, respectively. Multivariable Cox proportional hazards regression analysis revealed a significant association between elevated SHR and all-cause mortality. After adjusting for confounding variables, elevated SHR was significantly associated with increased risk of ICU mortality (hazard ratio [HR] = 1.67; 95% confidence interval [CI], 1.03-2.70)), in-hospital mortality (HR = 1.53; 95% CI, 1.00-2.33)), and 28-day all-cause mortality (HR = 1.49; 95% CI, 1.02-2.17)). Restricted cubic spline analysis demonstrated a significant U-shaped relationship between SHR and the risk of all-cause mortality. This study revealed that stress hyperglycemia ratio is an independent prognostic factor in patients with heart failure complicated by sepsis. Notably, both very high and very low SHR values were associated with increased mortality risk.
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页数:11
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