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Correlation between stress hyperglycemic ratio and all-cause mortality in diabetic patients with heart failure

Zhenrun Zhan1,2,3,4,5,6, Chao Lan1,2,3,4,5,6, Yongze Zhang1,2,3,4,5,6

  • 1Department of Endocrinology, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China.

BMC Endocrine Disorders
|August 6, 2025
PubMed

Insights

The stress hyperglycemia ratio (SHR) can predict mortality in diabetic patients with severe heart failure. Higher SHR levels indicate a greater risk of in-hospital and intensive care unit (ICU) death.

Area of Science:

  • Endocrinology
  • Cardiology
  • Critical Care Medicine

Background:

  • The stress hyperglycemia ratio (SHR) measures stress-induced hyperglycemia.
  • SHR is linked to poor outcomes in cardiovascular disease.
  • Its predictive value in diabetic patients with severe heart failure is not well-established.

Purpose of the Study:

  • To investigate the predictive value of SHR for mortality in diabetic patients with severe heart failure.
  • To assess the association between SHR and all-cause mortality in this population.

Main Methods:

  • Utilized the MIMIC-IV database for a cohort of diabetic heart failure patients.
  • Analyzed all-cause mortality as the primary outcome.
  • Employed restricted cubic spline, survival analysis, and Cox regression to assess SHR's impact.

Main Results:

  • 1470 patients were included; in-hospital and ICU mortality rates were 12.2% and 7.8%.
  • The highest SHR quartile group exhibited significantly higher in-hospital mortality.
  • A positive linear relationship was observed between SHR and mortality risk.

Conclusions:

  • SHR is significantly associated with in-hospital and ICU all-cause mortality in severe heart failure patients.
  • SHR may serve as a valuable tool for risk stratification in this patient group.
Abstract

Keywords:
All-cause mortalityDiabetesHeart failureStress hyperglycemic ratio

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