Prognostic value of glucose-to-lymphocyte ratio for all-cause mortality and consciousness impairment in critically ill cerebrovascular disease patients

Background The glucose-to-lymphocyte ratio (GLR) is a promising biomarker linked to metabolic status and inflammation, with prognostic value in various diseases. However, its role in predicting outcomes for patients with cerebrovascular diseases, particularly in intensive care units, remains unclear. Methods Data from 1,810 intracerebral hemorrhage (ICH) and 2060 ischemic stroke patients in the Medical Information Mart for Intensive Care IV database were analyzed. Cox proportional hazards models were used to evaluate the relationship between GLR and in-hospital mortality, while logistic regression assessed its association with consciousness impairment. Restricted cubic spline analysis was performed to examine potential non-linear links. The incremental predictive value of GLR was evaluated using decision curve analysis and integrated discrimination improvement indices. Results Elevated GLR was independently associated with higher in-hospital mortality in both ICH (hazard ratio [HR]: 1.016, P = 0.004) and ischemic stroke patients (HR: 1.013, P = 0.009). It was also linked to increased risk of consciousness impairment in ICH (odds ratio [OR]: 1.014, P = 0.043) and ischemic stroke (OR: 1.015, P = 0.013). Non-linear relationships between GLR and mortality were observed in ICH patients ( P for non-linearity < 0.001). Incorporating GLR into existing clinical scoring systems improved their predictive power (all P < 0.05). Conclusion GLR is a valuable predictor of severe consciousness impairment and in-hospital mortality in intensive care unit (ICU) patients with cerebrovascular diseases.