# Association between the stress hyperglycemia ratio and all-cause mortality in critically ill patients with T2DM: a retrospective study

## TL;DR

This study finds that the stress hyperglycemia ratio predicts mortality in critically ill patients with type 2 diabetes.

## Contribution

The study demonstrates the predictive value of the stress hyperglycemia ratio for mortality in critically ill T2DM patients.

## Key findings

- Elevated stress hyperglycemia ratio is significantly linked to 28-day, 90-day, and 180-day mortality in T2DM patients.
- Nonlinear associations were found between the stress hyperglycemia ratio and mortality risks at various time points.
- The findings suggest the stress hyperglycemia ratio can help identify high-risk patients early.

## Abstract

Previous studies have shown a significant correlation between the stress-hyperglycemia ratio (SHR) and mortality. However, it is unknown whether the SHR has the same predictive value in severely ill patients. The main purpose of this research was to investigate the association between the SHR and all-cause mortality in critically ill patients with T2DM.

The data used in this study were derived from the Medical Information Mart for Intensive Care (MIMIC-IV) database. The primary outcome was 180-day mortality and the secondary outcomes were 28-day, 90-day and 365-day mortality. The main analytical methods included: Kaplan-Meier survival analysis, the COX proportional hazards model and restricted cubic splines.

A total of 993 patients were included. The 28-day, 90-day, 180-day, and 365-day mortalities reached 10.4%, 14.4%, 16.7% and 19.0%, respectively. Multivariate Cox proportional hazards analysis revealed that the elevated SHR was significantly related to 28-day, 90-day and 180-day all-cause mortality even after cofounder adjustment. Restricted cubic spline analysis revealed a nonlinear association between the SHR and the risk of 28-day (p for nonlinear=0.014), 90-day (p for nonlinear=0.007), 180-day (p for nonlinear=0.001) and 365-day (p for nonlinear=0.003) all-cause mortality.

SHR is significantly associated with 28-day, 90-day and 180-day all-cause mortality in critically ill patients with T2DM. This may help us identify patients at higher risk of death early.