目的:探讨应激性高血糖比率(stress hyperglycemia ratio,SHR)与重症慢性阻塞性肺病(COPD)患者30天死亡率的相关性.方法:本研究基于重症监护医疗信息市场IV(Medical Information Mart for Intensive Care-IV,MIMIC-IV)数据库,纳入诊断为COPD的患者.主要结局事件为30天死亡率.根据SHR的四分位数将患者分组,采用生存分析与Cox回归分析评估SHR与30天死亡率的关联,并通过限制性立方样条分析确定其非线性关系.结果:SHR最高四分位组的30天死亡率显著高于其他组.经混杂因素校正后,与最低四分位组相比,最高四分位组的死亡风险显著增加.限制性立方样条图分析表明,SHR与30天死亡率之间存在"J"型非线性关系.结论:SHR升高与重症COPD患者30天死亡率的增加独立相关,SHR与重症COPD患者30天死亡率呈"J"型非线性关系.
Association between Stress Hyperglycemia Ratio and 30-day Mortality in Critically Ill Patients with COPD:A Retrospective Cohort Study from the MIMIC-IV Database
Objective:To investigate the correlation between stress hyperglycemia ratio(SHR)and 30-day mortality in patients with severe chronic obstructive pulmonary disease(COPD).Methods:This study was based on the Medical Information Mart for Intensive Care-IV(MIMIC-IV)database and included patients diagnosed with COPD.The primary outcome event was 30-day mortality.Patients were grouped according to the quartile of SHR,survival analysis and Cox regression analysis were used to assess the association between SHR and 30-day mortality,and the nonlinear relationship was determined by restricted cubic spline analysis.Results:The 30-day mortality was significantly higher in the highest quartile SHR group than in the other groups.After adjusting for confounders,the highest quartile group had a significantly increased risk of death compared to the lowest quartile group.Restricted cubic spline analysis showed that there was a"J"type nonlinear relationship between SHR and 30-day mortality.Conclusion:Increased SHR was independently associated with increased 30-day mortality in patients with severe COPD,and there was a"J"type nonlinear relationship between SHR and 30-day mortality in patients with severe COPD.
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