ArticleAmerican journal of translational research2026
Serum glucose-to-potassium ratio is associated with delirium and all-cause mortality in intensive care unit patients: insights from the MIMIC database analysis.
Article in American journal of translational research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThis study investigated the relationship between the glucose-to-potassium ratio (GPR) and intensive care unit (ICU) delirium as well as with all-cause mortality.
methodsWe analyzed 32,025 first-time ICU patients from MIMIC-IV v3.1, categorized by GPR quartiles. Multivariable logistic regression, restricted cubic splines (RCS) were used to analyze the GPR-delirium relationship. The optimal GPR cutoff was determined using ROC analysis. Propensity score matching (PSM) was performed to control confounders. Cox models assessed associations with 28-, 90-, and 365-day mortality. Mediation analysis evaluated delirium's role.
resultsDelirium incidence was 16.09% (n=5,152) and increased with GPR (Q1:13.93% vs. Q4:21.71%, P<0.001). After adjustment, Q4 had 58% higher delirium risk (OR=1.58, 95% CI 1.43-1.75). RCS showed a nonlinear positive association (P<0.001). The optimal GPR cutoff was 1.837 (AUC=0.829). After PSM, high GPR (≥1.837) remained a significant predictor (OR=1.43, 95% CI 1.24-1.64). High GPR was associated with high mortality at 28, 90, and 365 days (HR=1.17, 95% CI 1.08-1.28; HR=1.10, 95% CI 1.03-1.18; HR=1.11, 95% CI 1.05-1.18). Delirium mediated 19.067%, 32.218%, and 26.197% of the GPR-mortality relationship at these time points.
conclusionsElevated GPR is associated with higher delirium risk and short- and long-term mortality in ICU patients, with delirium partially mediating this relationship. GPR may serve as a practical biomarker for early risk stratification.
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