Stress-induced Hyperglycemia Ratio as an Independent Risk Factor of In-hospital Mortality in Nonresuscitation Intensive Care Units: A Retrospective Study

Tian, Yiming; Wang, Rui; Zhang, Mengmeng; Li, Tao; He, Ya‐Ling

doi:10.1016/j.clinthera.2022.12.007

Cited by 5 publications

(2 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nutritrauma can appear at any time during medical nutrition therapy in ICUs, but it is more common in the earliest phases of nutrition initiation and in patients receiving parenteral nutrition. The occurrence of nutritrauma has been associated with increased morbidity and mortality in critically ill patients [ 26 , 27 , 30 , 31 ], making its prevention vital. To avoid or minimize nutritrauma, a number of preventive measures are recommended, such as: adjusting the protein-caloric contribution to the patient’s clinical condition and the degree of metabolic stress; detecting and taking into account extra-nutritional caloric intake; maintaining the enteral route wherever possible, given its benefits for the intestinal mucosa [ 32 ]; having an effective glycemic control protocol; and measuring the fluid balance or analyzing the liver, lipid and electrolyte levels frequently [ 33 ].…”

Section: Conference Sectionsmentioning

confidence: 99%

Smartfeeding: A Dynamic Strategy to Increase Nutritional Efficiency in Critically Ill Patients—Positioning Document of the Metabolism and Nutrition Working Group and the Early Mobilization Working Group of the Catalan Society of Intensive and Critical Care Medicine (SOCMiC)

Yébenes,

Bordeje-Laguna,

Lopez-Delgado

et al. 2024

Nutrients

View full text Add to dashboard Cite

Adequate medical nutrition therapy for critically ill patients has an impact on their prognoses. However, it requires an individualized approach that takes into account the activity (phases of metabolic stress) and particularity of these patients. We propose a comprehensive strategy considering the patients’ nutritional status and the set of modifiable circumstances in these patients, in order to optimize/support nutritional efficiency: (1) A detailed anamnesis and an adequate initial nutritional assessment must be performed in order to implement medical nutrition therapy that is in line with the needs and characteristics of each patient. Furthermore, risks associated with refeeding syndrome, nutritrauma or gastrointestinal dysfunction must be considered and prevented. (2) A safe transition between nutrition therapy routes and between health care units will greatly contribute to recovery. The main objective is to preserve lean mass in critically ill patients, considering metabolic factors, adequate protein intake and muscle stimulation. (3) Continuous monitoring is required for the successful implementation of any health strategy. We lack precise tools for calculating nutritional efficiency in critically ill patients, therefore thorough monitoring of the process is essential. (4) The medical nutrition approach in critically ill patients is multidisciplinary and requires the participation of the entire team involved. A comprehensive strategy such as this can make a significant difference in the functional recovery of critically ill patients, but leaders must be identified to promote training, evaluation, analysis and feedback as essential components of its implementation, and to coordinate this process with the recognition of hospital management.

show abstract

Section: Conference Sectionsmentioning

confidence: 99%

Smartfeeding: A Dynamic Strategy to Increase Nutritional Efficiency in Critically Ill Patients—Positioning Document of the Metabolism and Nutrition Working Group and the Early Mobilization Working Group of the Catalan Society of Intensive and Critical Care Medicine (SOCMiC)

Yébenes,

Bordeje-Laguna,

Lopez-Delgado

et al. 2024

Nutrients

View full text Add to dashboard Cite

show abstract

“… 2 Many studies have examined the effect of cortisol levels and blood sugar regulation on intensive care mortality and morbidity in patients followed up in the intensive care unit (ICU). 3 , 4 However, studies examining the effects of blood cortisol levels before admission to the ICU and glycosylated hemoglobin (HBA1C) levels, which reflect blood sugar regulation over the last 2-3 months, on morbidity and mortality in the ICU are scarce.…”

mentioning

confidence: 99%

Effect of cortisol and glycosylated-hemoglobin levels on mortality in intensive care unit

Sen,

Uzun,

Aydin

et al. 2024

SMJ

View full text Add to dashboard Cite

Stress hyperglycemia ratio and its influence on mortality in elderly patients with severe community-acquired pneumonia: a retrospective study

Miao,

Shen,

et al. 2024

Aging Clin Exp Res

View full text Add to dashboard Cite

Background Community-acquired pneumonia (CAP) is a significant health issue among the elderly, with severe cases (SCAP) having high mortality rates. This study assesses the predictive significance of the stress hyperglycemia ratio (SHR) in elderly SCAP patients and its impact on outcomes in both diabetic and non-diabetic patients. Methods and materials This retrospective study included 406 SCAP patients aged 65 or older from the Second People’s Hospital of Lianyungang (January 2020 to December 2023). Data collected included demographics, medical history, vital signs, and lab results. SHR was calculated from initial blood glucose and estimated average glucose (HbA1c). Statistical analyses, including Cox regression and Kaplan-Meier analysis, evaluated SHR’s impact on mortality. Mediation models explored the effects of neutrophil-lymphocyte ratio (NLR) and SHR. Results The 28-day mortality rate was 21.67%. Deceased patients had higher age, Charlson Comorbidity Index, procalcitonin, NLR, glucose, and SHR levels compared to survivors (P < 0.05). Both SHR and NLR significantly increased mortality risk, particularly in non-diabetic patients. Combining NLR and SHR improved ROC AUC to 0.898, with 89.80% sensitivity and 81.10% specificity. Kaplan-Meier analysis showed higher cumulative survival for SHR < 1.14, regardless of diabetes status (P < 0.05). NLR mediated 13.02% of the SHR-survival relationship, while SHR mediated 14.06% of the NLR-survival relationship. Conclusion Elevated SHR is a significant mortality risk factor in elderly SCAP patients, independent of diabetes status. Stringent glucose control and careful monitoring of SHR may improve outcomes in elderly patients with acute respiratory conditions.

show abstract

Stress-induced Hyperglycemia Ratio as an Independent Risk Factor of In-hospital Mortality in Nonresuscitation Intensive Care Units: A Retrospective Study

Cited by 5 publications

References 29 publications

Smartfeeding: A Dynamic Strategy to Increase Nutritional Efficiency in Critically Ill Patients—Positioning Document of the Metabolism and Nutrition Working Group and the Early Mobilization Working Group of the Catalan Society of Intensive and Critical Care Medicine (SOCMiC)

Smartfeeding: A Dynamic Strategy to Increase Nutritional Efficiency in Critically Ill Patients—Positioning Document of the Metabolism and Nutrition Working Group and the Early Mobilization Working Group of the Catalan Society of Intensive and Critical Care Medicine (SOCMiC)

Effect of cortisol and glycosylated-hemoglobin levels on mortality in intensive care unit

Stress hyperglycemia ratio and its influence on mortality in elderly patients with severe community-acquired pneumonia: a retrospective study

Contact Info

Product

Resources

About