Impact of stress hyperglycemia ratio on acute kidney injury and mortality in patients with cardiogenic shock: a retrospective analysis

Aims This study investigated the predictive value of the stress hyperglycemia ratio (SHR) for acute kidney injury (AKI) and mortality in cardiogenic shock (CS). Methods A retrospective analysis was conducted on patients with CS from the Medical Information Mart for Intensive Care IV database based on SHR values. The primary outcome was AKI incidence, with in-hospital and 90-day mortality as secondary outcomes in the subgroup with AKI. Logistic regression assessed the relationship between SHR and AKI as well as in-hospital mortality, while Cox regression was employed to evaluate 90-day mortality. Restricted cubic spline curves were utilized to explore nonlinear associations. Results Among 378 patients with CS, 56.9% developed AKI. Elevated SHR was associated with a higher risk of AKI (OR 2.58, 95% CI 1.44–4.81). In the AKI subgroup, SHR exhibited a U-shaped relationship with mortality ( P for non-linearity < 0.05). An SHR above 1.26 was linked to increased in-hospital (OR 2.74, 95% CI 1.35–5.80) and 90-day mortality (HR 2.84, 95% CI 1.95–4.13). Conclusions SHR is independently associated with both AKI and mortality in CS. A U-shaped curve suggests that optimal glycemic control may improve patient outcomes. Prospective studies are needed to validate these findings and further investigate SHR as a prognostic marker.