Evidence map›Paper›PMID 41620677›Full record

ArticleBMC cardiovascular disorders2026

Stress hyperglycemia ratio and mortality risk in cardiometabolic multimorbidity: a multicenter retrospective study.

Jing Tian, Xinyi Chang, Yue Guo, Jun Liu, Dian Yu, Xiaoyun Song, Yi Han

Abstract readMulticenter Study
In one paragraph

Article in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Jing Tian *Department of Critical Care Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China.
Xinyi Chang *Department of Critical Care Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China.
Yue GuoDepartment of Critical Care Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China.
Jun LiuDepartment of Critical Care Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China.
Dian YuDepartment of Critical Care Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Xiaoyun SongDepartment of Critical Care Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Yi HanDepartment of Critical Care Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China. yihanharbin@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThis study aimed to investigate the association between the Stress Hyperglycemia Ratio (SHR) and mortality risk in critically ill patients with cardiometabolic multimorbidity (CMM), and to explore the potential mediating roles of white blood cell count (WBC), albumin, and creatinine.

methodsWe conducted a multicenter retrospective cohort study using data from the MIMIC-IV database (n = 1,214) for derivation and the NWICU database (n = 686) for external validation. The relationship between SHR and all-cause/28-day mortality was analyzed using multivariate logistic regression, restricted cubic splines, and machine learning models. Mediation analysis was performed to assess the roles of WBC, albumin, and creatinine.

resultsA nonlinear relationship with threshold effects was observed between SHR and mortality. In the fully adjusted model, the highest SHR tertile (Q3) was independently associated with increased risks of all-cause mortality (OR = 1.58, 95% CI: 1.13–2.20) and 28-day mortality (OR = 1.98, 95% CI: 1.24–3.18). Random Forest and XGBoost models demonstrated the best predictive performance for 28-day mortality (AUC = 0.765). Calibration curves confirmed the reliability of the risk estimates. Mediation analysis indicated that WBC and creatinine may partially mediated the adverse effects of SHR, while albumin exerted a protective mediating effect.

conclusionsSHR is a significant and independent predictor of mortality in critically ill patients with CMM, exhibiting a nonlinear association. WBC, creatinine, and albumin may partially mediate this relationship, offering insights for future mechanistic studies. However, these findings are specific to the ICU population and warrant further validation in other cohorts.

Indexed as

Blood GlucoseHyperglycemiaStress, PhysiologicalAgedBiomarkersCause of DeathCreatinineCritical IllnessDatabases, FactualFemaleHumansLeukocyte CountMaleMiddle AgedMultimorbidityPredictive Value of TestsALB protein, humanBiomarkersBlood GlucoseCreatinineSerum Albumin, HumanCardiometabolic multimorbidityMachine learningMortality riskStress Hyperglycemia Ratio

Identifiers

PMID41620677
PMCPMC12947501

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.