Prognostic Value of Stress Hyperglycemia Ratio in Critically Ill Patients
Prognostic Value of Stress Hyperglycemia Ratio for In-Hospital Mortality and Acute Organ Dysfunction in Critically Ill Patients
Critically ill patients admitted to intensive care units (ICUs) frequently develop elevated blood sugar levels (hyperglycemia) as a result of acute illness-related stress, even if they do not have diabetes. While high blood glucose in the ICU is known to be associated with complications such as acute kidney injury and increased mortality, absolute glucose measurements alone may not distinguish acute stress from pre-existing chronic elevation.
The Stress Hyperglycemia Ratio (SHR) evaluates the relative increase in blood glucose by dividing admission plasma glucose by the patient's estimated background average glucose derived from glycated hemoglobin (HbA1c). This measurement reflects the intensity of acute physiologic stress adjusted for baseline glycemic control.
The purpose of this prospective observational study is to evaluate the prognostic utility of admission Stress Hyperglycemia Ratio in adult critically ill patients admitted to the intensive care units of Assiut University Hospitals. The study aims to determine whether admission SHR can predict in-hospital ICU mortality, acute kidney injury (AKI), the severity of acute organ failure measured by Sequential Organ Failure Assessment (SOFA) scores, the requirement and duration of invasive mechanical ventilation and vasopressor support, and the overall length of ICU stay.
All participants will receive standard clinical care in accordance with institutional ICU protocols; no experimental drugs or clinical interventions will be administered as part of this study.
調査の概要
研究の種類
入学 (推定)
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
Adult critically ill patients aged 18 years or older admitted to the Intensive Care Units (ICUs) at Assiut University Hospitals who are expected to require intensive care management, with available admission plasma glucose and early HbA1c measurements.
説明
Inclusion Criteria:
- Adult patients aged 18 years or older.
- Admitted to the intensive care unit (ICU) and expected to require ICU care.
- Availability of admission plasma glucose measurement.
- Availability of glycated hemoglobin (HbA1c) measurement during the early period of ICU admission to calculate estimated average glucose (eAG) and Stress Hyperglycemia Ratio (SHR).
- Provision of written informed consent by the patient or their legally authorized representative.
Exclusion Criteria:
- Patients younger than 18 years of age.
- Presence of diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS) at admission.
- Conditions known to render HbA1c measurement unreliable (such as recent major blood transfusion or known hemoglobinopathies).
- Incomplete essential laboratory or clinical data required for the calculation of SHR or study outcome assessment.
- Patients transferred from another ICU after prolonged critical illness where baseline admission parameters cannot be reliably obtained.
- Refusal of participation or refusal of consent by the patient or legally authorized representative.
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 観測モデル：COHORT
- 時間の展望：PROSPECTIVE
コホートと介入
グループ/コホート |
|---|
|
High Stress Hyperglycemia Ratio (High SHR) Group
Adult critically ill patients admitted to the ICU whose admission Stress Hyperglycemia Ratio (SHR) - calculated as admission plasma glucose divided by estimated average glucose (eAG = 28.7 * HbA1c - 46.7) - falls at or above the optimal cutoff determined by receiver operating characteristic (ROC) analysis. Participants receive standard medical care per ICU protocols without experimental intervention. |
|
Low Stress Hyperglycemia Ratio (Low SHR) Group
Adult critically ill patients admitted to the ICU whose admission Stress Hyperglycemia Ratio (SHR) - calculated as admission plasma glucose divided by estimated average glucose (eAG = 28.7 * HbA1c - 46.7) - falls below the optimal cutoff determined by receiver operating characteristic (ROC) analysis. Participants receive standard medical care per ICU protocols without experimental intervention. |
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Number of Participants With In-Hospital ICU Mortality
時間枠：Up to 30 days
|
All-cause mortality occurring during the index ICU stay. Vital status (alive or deceased) will be recorded from patient medical records upon discharge from the intensive care unit. |
Up to 30 days
|
協力者と研究者
スポンサー
研究記録日
主要日程の研究
研究開始 (推定)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- Prognostic Value of SHR in ICU
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