Role of stress hyperglycemia ratio in the prediction of delirium in patients with heart failure.

AIMS: The objective of this study was to investigate the association between the stress hyperglycemia ratio (SHR) and the likelihood of developing delirium in patients with heart failure (HF).

METHODS

The present study utilized data from the Medical Information Mart for Intensive Care IV database, with a particular focus on adult patients diagnosed with HF who were admitted to the intensive care unit (ICU) for the first time. Patients were stratified into quartiles based on their SHR. The primary outcome of interest was the occurrence of delirium, with secondary outcomes encompassing all-cause mortality at 90, 180, and 360 days. The employment of Cox proportional hazards regression models was undertaken to evaluate the association between SHR and the outcomes. A restricted cubic spline analysis was conducted to investigate potential non-linear relationships between SHR and the primary and secondary outcomes.

RESULTS

A total of 4425 patients with a median age of 71.51 years were included in the study. The overall incidence of delirium was 35.3 %, with the Quartile 4 (Q4) group demonstrating a significantly higher incidence compared to other quartiles. Following adjustment for confounding variables, a significant positive association was observed between the SHR and the presence of delirium. Furthermore, the 90-, 180-, and 360-day all-cause mortality rates were found to be considerably elevated in the Q4 group.

CONCLUSIONS

SHR is a significant predictor of an elevated risk of delirium and long-term all-cause mortality in patients suffering from HF, highlighting its potential as a prognostic indicator in this particular population.