Prognostic value of stress hyperglycemia ratio versus triglyceride-glucose index in critically ill elderly patients with stroke
LIU Yudan
REN Zhuangzhuang
QI Xiaokun
LIU Jianguo
SUN Chenjing
Abstract：Objective To compare the predictive value of stress hyperglycemia ratio(SHR)and triglyceride-glucose index(TyG)for short-term all-cause mortality in elderly critically ill stroke patients.Methods A retrospective study was conducted on the 1800 ICU patients with cerebrovascular diseases based on the Medical Information Mart for Intensive Care-Ⅳ database.Based on the quartiles of SHR and TyG,patients were categorized into Q1,Q2,Q3 and Q4 groups.The primary outcome was 30-day all-cause mortality after ICU admission,and the 7-and 90-day mortality incidences were taken as secondary outcomes.Kaplan-Meier survival analysis was used to construct survival curves.Multivariate Cox proportional hazards regression was employed to assess the risk of patient mortality.ROC curves were used to evaluate the predictive performance of SHR and TyG at 7-,30-,and 90-day.Results With the increase of SHR quantile,the 7-,30-,and 90-day mortality incidences were gradually raised(P＜0.01),and the survival curves showed consistent risk stratification across SHR quartiles at all time points(Log-rank P＜0.01).Multivariate Cox regression analysis showed a clear dose-response relationship in SHR.Compared with the Q1 group,the Q4 group had a significantly increased risk of 30-day mortality(HR=2.63,95％CI:1.77-3.89,P＜0.01).TyG was associated with 7-and 30-day mortality risk,but not with the 90-day mortality risk among 4 groups(P＞0.05),without showing a clear gradient.Time-dependent ROC curve analysis indicated that the AUC values of the addition of SHR increased to 0.680,0.750 and 0.753,respectively,but adding TyG had no such significant effect.The predictive performance was not improved notably after the combination of SHR and TyG.Conclusion In elderly critically ill stroke patients,SHR demonstrates superior and more stable discriminative performance than TyG in predicting short-term all-cause mortality,and may serve as a potential practical biomarker for early risk stratification.
Keywords：senile diseasecerebrovascular diseasecritical illness
Publication Date：2026-03-15
Online Publishing Date：2026-03-31(First online date of this platform, not the publication date of the document)
Pages：5( 353-357 )