Stress Hyperglycemia Ratio as a Predictor of All-Cause Mortality in Patients With Non-Traumatic Intracerebral Hemorrhage: From the MIMIC-IV Database.

BackgroundStress hyperglycemia ratio (SHR) reflects the acute glycemic response to physiological stress. This study aimed to investigate the association between SHR and clinical outcomes in hospitalized patients with intracerebral hemorrhage (ICH).MethodData were extracted from the MIMIC-IV database. SHR was calculated using the following formula: admission blood glucose (mg/dL)/(28.7 × HbA1c (%) - 46.7). Restricted cubic spline (RCS) curves were utilized to explore potential nonlinear relationships between SHR and outcomes. Cox regression models were employed to assess the association between SHR and in-hospital mortality, and Kaplan-Meier curves were used to examine survival outcomes.ResultsA total of 1663 inpatients with ICH were included, with an in-hospital mortality rate of 7.5% (125/1663). RCS analysis revealed a significant non-linear association between SHR and the risk of all-cause mortality (all P < 0.05 for non-linearity). In the multi-variable Cox regression analysis, a higher SHR was significantly associated with an increased risk of all-cause mortality [adjusted HR =2.13 (95%CI 1.20-3.70), P = 0.009]. This positive association remained consistent across specific subgroups, including individuals aged > 65 years [HR 3.23 (95% CI 1.14-9.09)], females [HR 3.33 (95% CI 1.43-7.69)], and those with diabetes [HR 2.94 (95% CI 1.54-5.88)], COPD [HR 2.86 (95% CI 1.64-4.76)], or CKD [HR 3.03 (95% CI 1.61-5.56)].ConclusionA significant non-linear relationship was observed between SHR and all-cause mortality in hospitalized patients with ICH. Elevated SHR may serve as a potential predictor of poor prognosis in patients with ICH.