The Prognostic Significance of Stress Hyperglycemic Ratio in Critically Ill Patients with Hypertension: A Study Using the MIMIC-IV Database

Stress hyperglycemia is a common phenomenon in critically ill patients and has been associated with adverse outcomes. While the SHR index has been shown to be an independent risk factor for in-hospital mortality in critical illness, its prognostic significance specifically in hypertensive patients remains understudied. Our research aims to fill this gap by examining the correlation between the SHR index and overall mortality among critically ill hypertensive individuals using the MIMIC-IV database.Our study included 2,140 participants with a mean age of 69.5 years, of whom 55.1% were male. We found that elevated SHR index levels were significantly associated with increased all-cause mortality at various time points (30, 90, 180, and 365 days). The Cox proportional hazards regression analyses confirmed the significant association between the SHR index and mortality risk, even after adjusting for potential confounders. Additionally, restricted cubic spline analysis revealed an inverse U-shaped relationship between the SHR index and mortality rates at 30, 90, and 180 days, with an inflection point of 1.76. Subgroup analyses also highlighted differences in the SHR index and mortality across various demographic and clinical subgroups.We believe that our findings have important clinical implications. The SHR index can serve as a valuable indicator to assess the severity of hypertensive patients' conditions in the ICU, potentially aiding in the development of targeted interventions to improve outcomes.