A Prospective Observational Study Of Association Of Stress Hyperglycaemia Ratio (Shr) And The Clinical Outcomes In Critically Ill Patients

Boddu  Jyotirmayi; Gandhi  Parise; V.C.Srinivas  Reddy; Rajanish  Chandra

Authors

Boddu Jyotirmayi MD-Associate Professor, General Medicine, Government Siddhartha Medical College, Vijayawada, Andra Pradesh, India
Gandhi Parise MD-Associate Professor, General Medicine, Government Siddhartha Medical College, Vijayawada, Andra Pradesh, India
V.C.Srinivas Reddy MD-Associate Professor, General Medicine, Government Siddhartha Medical College, Vijayawada, Andra Pradesh, India
Rajanish Chandra MBBS- Medical Intern, General Medicine, Government Siddhartha Medical College, Vijayawada , Andra Pradesh, India

Keywords:

Stress hyperglycaemia ratio; Critical illness; Intensive care unit; Mortality; Mechanical ventilation; APACHE score; Prognostic biomarker.

Abstract

Background: Stress hyperglycaemia ratio (SHR), which adjusts admission blood glucose for chronic glycaemic status using HbA1c, is a more reliable marker of acute metabolic stress than admission blood glucose alone. Prospective evidence from heterogeneous critically ill patients in the Indian ICU setting remains limited.
Objectives: To evaluate the association between SHR and clinical outcomes, including in-hospital mortality, ICU length of stay, mechanical ventilation, vasopressor requirement in critically ill adults.
Methods: A prospective observational study was conducted amongcritically ill adults in medical ICU of a tertiary care hospital. SHR was calculated using admission blood glucose and HbA1c. Clinical outcomes included mortality, ICU length of stay, mechanical ventilation, vasopressor requirement, and APACHE score. Statistical significance was defined as p<0.05.
Results: The mean age was 58.5±12 years. Overall in-hospital mortality was 23.5%. Mean SHR was significantly higher among non-survivors than survivors (1.46 vs. 1.10; p<0.001). Mortality increased progressively as SHR increases. Patients requiring mechanical ventilation and vasopressor support also demonstrated higher SHR values.
Conclusions: SHR is a simple and readily available biomarker for early risk stratification in critically ill patients. Routine assessment of SHR may improve prognostication and guide early clinical decision-making.