Abstract：
Previous research have demonstrated that the stress hyperglycemia ratio (SHR) accurately reflects acute hyperglycemic states and correlates with adverse outcomes. This study aims to explore the relationship between SHR and the prognosis of patients with aneurysmal subarachnoid hemorrhage (aSAH). Patients with aSAH were categorized into four groups based on SHR tertiles. Functional outcomes were evaluated at 12 months using the modified Rankin Scale (mRS), with scores ranging from 0 to 2 indicating a good outcome and 3-6 indicating a poor outcome. The associations between SHR and functional outcomes were analyzed using logistic regression models and restricted cubic spline analysis. A total of 127 patients exhibited poor functional outcomes. Following comprehensive adjustments, those in the highest SHR tertile had a significantly increased risk of poor prognosis compared to those in the lowest tertile (odds ratio [OR], 4.12; 95% confidence interval [CI]: 1.87-9.06). Moreover, each unit increase in SHR was associated with a 7.51-fold increase in the risk of poor prognosis (OR, 7.51; 95% CI: 3.19-17.70). Further analysis using restricted cubic spline confirmed a linear correlation between SHR and poor prognosis (P for nonlinearity = 0.609). Similar patterns were observed across all studied subgroups. Elevated SHR significantly correlates with poor functional prognosis at one year in patients with aSAH, independent of their diabetes status.
摘要：
先前的研究表明，应激性高血糖率（SHR）准确反映了急性高血糖状态，并与不良结局相关。本研究旨在探讨SHR与动脉瘤性蛛网膜下腔出血(aSAH)患者预后的关系。根据SHR三元组将aSAH患者分为四组。在12个月时使用改良的Rankin量表（mRS）评估功能结果，分数从0到2表示良好的结果，3-6表示较差的结果。使用逻辑回归模型和有限三次样条分析分析SHR与功能结果之间的关联。共有127例患者表现出不良的功能结果。经过全面调整，与最低三位数的人相比，SHR最高三位数的人预后不良的风险显着增加（比值比[OR]，4.12；95%置信区间[CI]：1.87-9.06)。此外，SHR每增加一个单位与不良预后风险增加7.51倍相关(OR,7.51；95%CI：3.19-17.70）。使用受限三次样条的进一步分析证实了SHR与不良预后之间的线性相关（非线性的P=0.609）。在所有研究的亚组中观察到类似的模式。SHR升高与aSAH患者一年时的不良功能预后显着相关，与他们的糖尿病状况无关。
