Assessing the stress hyperglycemia ratio in hyperlipidemia patients to predict all-cause mortality: A retrospective...

The Stress Hyperglycemia Ratio (SHR) reflects stress-related hyperglycemia and is linked to poor outcomes in various diseases. This study explores the association between SHR and all-cause mortality in hyperlipidemia patients and its value in enhancing predictive models.

Data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) included 4,883 first-admission hyperlipidemia patients. Patients were grouped by SHR quartiles. Outcomes included in-hospital, ICU, and 28-day mortality. Cox regression, restricted cubic spline (RCS), and ROC curves were used. Seventeen machine learning models assessed SHR's predictive value, with LightGBM evaluating variable importance.

We extracted data from 4,883 first-admission hyperlipidemia patients aged 18-100 years (mean age 70 ± 12.1; 36.0 % female). SHR was independently associated with ICU mortality (HR = 1.29, 95 % CI 1.08-1.56), in-hospital mortality (HR = 1.24, 95 % CI 1.07-1.44), and 28-day mortality (HR = 1.32, 95 % CI 1.15-1.52). RCS analysis showed a linear association between SHR and mortality. Adding SHR to general models improved predictive accuracy.

In the study of first-admission hyperlipidemia patients, elevated SHR levels were significantly associated with in-hospital, ICU, and 28-day all-cause mortality. Incorporating SHR into existing models enhances their predictive ability, holding significant clinical value for identifying high-risk patients.