Stress hyperglycemia ratio as a prognostic biomarker for mortality in ICU patients with cerebral infarction: a retrospective cohort study

 

Biomarkers DO NOTHING FOR RECOVERY! Because you don't have recovery protocols mapped to the problems found. Can't anyone in stroke think at all?

Oops, I'm not playing by the polite rules of Dale Carnegie,  'How to Win Friends and Influence People'. 

Telling stroke medical persons they know nothing about stroke is a no-no even if it is true. 

Politeness will never solve anything in stroke. Yes, I'm a bomb thrower and proud of it. Someday a stroke 'leader' will try to ream me out for making them look bad by being truthful, I look forward to that day.

Send me personal hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name(If you can't stand by your name don't bother replying anonymously) and my response in my blog. Or are you afraid to engage with my stroke-addled mind? No excuses are allowed! You're medically trained; it should be simple to precisely state EXACTLY WHY you aren't working on 100% recovery protocols with NO EXCUSES!

Stress hyperglycemia ratio as a prognostic biomarker for mortality in ICU patients with cerebral infarction: a retrospective cohort study

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https://doi.org/10.1016/j.jocn.2025.111694Get rights and content

Abstract

Background

The prognostic value of stress hyperglycemia ratio (SHR) in cerebral infarction remains underexplored. This study aimed to evaluate the association between SHR and mortality in critically ill patients with cerebral infarction.

Methods

A retrospective cohort study was conducted using data from the MIMIC-IV database (2008–2022). Adults with cerebral infarction admitted to the ICU were included. SHR was calculated as admission glucose/(28.7 × HbA1c − 46.7). Tertiles of SHR (T1–T3) were analyzed for mortality outcomes using Kaplan-Meier and Cox proportional-hazards models.

Results

Among 1,830 patients, the highest SHR tertile (T3) had significantly increased risks of in-hospital mortality (adjusted HR = 1.77, 95 %CI 1.38–2.26) and 365-day mortality (HR = 1.55, 95 %CI 1.28–1.87) compared to T1. A linear dose–response relationship was observed between SHR and mortality (P-trend < 0.001). Subgroup analyses revealed consistent associations across age, sex, and comorbidities, with heightened risk in patients receiving mechanical thrombectomy (HR = 5.67, 95 %CI 2.29–14.04).

Conclusion

SHR serves as an independent predictor for both short-term and long-term all-cause mortality in patients with cerebral infarction in the ICU, and shows potential as a tool for risk stratification in this patient population.