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Relationship between stress hyperglycemia ratio and gastrointestinal bleeding and mortality after coronary artery
Jiale Dong1, Jian Yang2, Zhechuan Jin3
1Department of Acute Abdomen Surgery, General Surgery Center, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China.
Insights
The stress hyperglycemia ratio (SHR) shows a U-shaped link with gastrointestinal bleeding and mortality after coronary artery bypass grafting. Both low and high SHR levels may indicate higher patient risk.
Area of Science:
- Cardiology
- Gastroenterology
- Critical Care Medicine
Background:
- Gastrointestinal bleeding after coronary artery bypass grafting (GIBCG) is a severe complication associated with increased mortality.
- The stress hyperglycemia ratio (SHR) is a known predictor of adverse outcomes in cardiovascular disease patients.
Purpose of the Study:
- To investigate the association between the stress hyperglycemia ratio (SHR) and the incidence of GIBCG.
- To examine the relationship between SHR and in-hospital mortality following coronary artery bypass grafting.
Main Methods:
- Analysis of 16,440 patients from four medical centers and the MIMIC-IV database.
- Categorization of patients into four groups based on SHR quartiles.
- Utilized restricted cubic splines and logistic regression to analyze SHR's relationship with outcomes.
Main Results:
- A U-shaped relationship was observed between SHR and both GIBCG (7.04% incidence) and in-hospital mortality (1.3% incidence).
- The lowest incidence of GIBCG and mortality occurred within an SHR range of 0.706-0.792.
- Inflection points for GIBCG and mortality were identified at SHR values of 0.71 and 0.733, respectively.
Conclusions:
- A significant U-shaped association exists between SHR and both GIBCG and in-hospital mortality post-coronary artery bypass grafting.
- Both low and high SHR levels can identify patients at elevated risk for these adverse outcomes.
Background:
Gastrointestinal bleeding after coronary artery bypass grafting (GIBCG) is a serious postoperative complication linked to increased mortality. The stress hyperglycemia ratio (SHR) has been recognized as a reliable predictor of adverse clinical outcomes, particularly in patients with cardiovascular disease. This study aimed to investigate the association between SHR and both GIBCG and in-hospital mortality.
Methods:
Patients were recruited from four medical centers and the Medical Information Mart for Intensive Care IV, with a total of 16,440 individuals included in the final analysis. Patients were categorized into four groups based on SHR quartiles. The primary outcomes of interest were the incidence of GIBCG and in-hospital mortality. Restricted cubic splines and logistic regression models were employed to analyze the relationship between SHR and clinical outcomes.
Results:
Among the patients who underwent surgery, 1,158 (7.04%) experienced GIBCG, while 214 (1.3%) died during hospitalization. After adjusting for confounding variables, a U-shaped relationship was observed between SHR and both GIBCG occurrence and in-hospital mortality. The lowest incidence of these outcomes was observed within the SHR range of 0.706-0.792, with inflection points identified at 0.71 for GIBCG and 0.733 for in-hospital mortality.
Conclusion:
A U-shaped relationship was identified between SHR and both GIBCG and in-hospital mortality. Both low and high SHR levels may help identify patients at increased risk of gastrointestinal bleeding and in-hospital mortality following coronary artery bypass grafting.
