Correlation between stress hyperglycemia ratio and delusion in elderly patients with severe pneumonia
Objective:To investigate the predictive value of stress hyperglycemia ratio(SHR)on delirium in elderly patients with severe pneumonia and its influence on prognosis.Methods:Clinical data of 260 patients aged≥60years old with severe pneumonia,who were admitted to the Department of Intensive Care Medicine of our hospital from January 2021 to January 2024,were retrospectively collected.SHR was calculated by dividing the blood glucose at admission by the estimated average blood glucose.The occurrence of delirium during hospitaliza-tion was recorded.Confusion assessment methods of intensive care Unit(CAM-ICU)was used for delirium assess-ment,and the patients were divided into survival group and death group according to the follow-up results after 28 days.Spearman rank correlation analysis was performed to examine the correlation between SHR and inflammato-ry markers.An ROC curve was used to analyze the predictive value of SHR for delirium,Kaplan-Meier survival analyses were generated,and log-rank tests were used to compare differences in cumulative survival among pa-tients in different SHR groups.Results:Among 260 elderly patients with severe pneumonia,46 cases died,resul-ting in a 28-day fatality rate of 17.69％.The incidence of delirium was higher in the death group compared to the survival group(60.87％vs.29.91％,P＜0.05).The death group had higher age and acute physiology and chron-ic health evaluation scores than those in the survival group,as well as elevated levels of BUN,PCT,IL-6,Lac and SHR compared to the survival group(P＜0.05).The incidence of delirium was 35.38％,and the 28-day mor-tality in the delirium group was higher than that in the non-delirium group(30.43％vs.10.71％,P＜0.05).IL-6,Lac,and SHR were higher in the delirium group compared to those in non-delirium groups(P＜0.05),but there were no significant differences observed between both groups regarding PCT,hs-CRP,and glycated hemo-globin(P＞0.05).SHR showed positive correlations with PCT,IL-6,and Lac,with correlation coefficients r of 0.210,0.397,and 0.409 respectively(all P＜0.05).The area under the curve(AUC)of SHR for predicting de-lirium was 0.720(95％CI:0.659-0.782).When the SHR cut-off point was 1.07,the sensitivity was 80.40％and the specificity was 53.60％.Kaplan-Meier survival curve analysis revealed statistically significant differences in cumulative survival rates among elderly patients with severe pneumonia when divided into four groups based on quartiles of SHR values(x2=60.093,P＜0.001).Conclusion:SHR can be used to predict the occurrence of de-lirium in elderly patients with severe pneumonia during hospitalization,and an increase in SHR indicates poor prognosis.
old agesevere pneumoniastress hyperglycemia ratiodeliriumprognosis
万方数据
维普
