{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"PACUPod: Critical Care","title":"Stress hyperglycemia ratio as a biomarker for early mortality risk stratification in cardiovascular disease a propensity matched analysis summary","html":"","width":"100%","height":180,"duration":359,"description":"{\"episode_description\":\"PACULit Daily Literature Update: Stress hyperglycemia ratio as a biomarker for early mortality risk stratification in cardiovascular disease — a propensity matched analysis. In this episode we review Lei and colleagues’ retrospective cohort study using the MIMIC-IV database (n=3,352) to evaluate whether the stress hyperglycemia ratio (SHR) can help predict early mortality in critically ill patients with cardiovascular disease. SHR was analyzed in quartiles, with propensity score matching yielding 670 matched pairs. Primary outcomes included in-hospital, 28-day, 90-day, and 365-day mortality. Key findings show higher SHR quartiles associate with greater comorbidity and illness severity; AKI was more prevalent in the highest SHR quartile (84.6% vs 79.7%). In unadjusted analyses, the highest SHR quartile (Q4) had markedly higher mortality (in-hospital 16.3% vs 5.1–6.4%; 365-day 29.2% vs 15.7–16.9%). Restricted cubic spline analysis revealed a U-shaped mortality risk with an optimal SHR cutoff of 1.355. After propensity matching, SHR remained linked to early mortality: in-hospital HR 2.12 (95% CI 1.22–3.67) and 28-day HR 1.86 (95% CI 1.10–3.14). Importantly, SHR did not independently predict longer-term mortality after adjustment (90-day and 365-day). Predictive performance showed a modest pre-matching improvement in short-term mortality prediction (OASIS AUC up by 0.034 for in-hospital mortality); this benefit diminished after matching and did not","thumbnail_url":"https://img.transistorcdn.com/W5ppyJiVvpeq5HNrnsz_zaMmU5rmab3dOuTiTdwfeYQ/rs:fill:0:0:1/w:400/h:400/q:60/mb:500000/aHR0cHM6Ly9pbWct/dXBsb2FkLXByb2R1/Y3Rpb24udHJhbnNp/c3Rvci5mbS9hMTdi/ZTcyYTUyYTdmMmY2/Y2VmYzc4ZmIwYzA4/NTdlMC5wbmc.webp","thumbnail_width":300,"thumbnail_height":300}