Correlation between stress hyperglycemia ratio and risk of acute respiratory distress syndrome in patients with sepsis: a MIMIC-IV cohort study.

This study aimed to investigate the association between stress hyperglycemia ratio (SHR) and the risk of acute respiratory distress syndrome (ARDS) in patients with sepsis. Data were extracted from the Medical Information Mart for Intensive Care - IV database in this retrospective cohort study. Participants were stratified into four groups based on the interquartile range of SHR. The primary outcome measure was the incidence of in-hospital ARDS. Multivariate Cox proportional-hazards regression and restricted cubic splines models were employed to evaluate the correlation between the SHR index and ARDS risk in patients with sepsis. Subgroup analysis and K-M survival curve analysis were also conducted. A total of 1,946 patients (59% male) were included in the study. The incidence of ARDS and in-hospital mortality was 34% and 13%, respectively. Multivariate Cox regression analysis revealed that the SHR index was independently associated with an increased risk of in-hospital ARDS and mortality. The RCS model indicated an approximately linear increase in the risk of both ARDS and in-hospital mortality with a rising SHR index. Subgroup analysis demonstrated consistent results. In conclusion, elevated SHR was significantly associated with a higher risk of ARDS and in-hospital all-cause mortality in sepsis patients.