Predictive value of stress hyperglycemia ratio for perioperative hidden blood loss in patients with hip fractures: a retrospective cohort study

Objective To investigate the predictive value of stress hyperglycemia ratio (SHR) for perioperative hidden blood loss (HBL) in patients with hip fractures. Methods A retrospective analysis was conducted on 152 patients with hip fractures admitted to our hospital from January 2021 to December 2023. Patients were divided into an HBL group ( n = 52) and a non-HBL group ( n = 100) based on the occurrence of HBL during the perioperative period. Univariate and binary Logistics regression analyses were used to identify influencing factors. The receiver operating characteristic (ROC) curve was employed to evaluate the predictive value of SHR for perioperative HBL in hip fracture patients. Results There were statistically significant differences ( p < 0.05) in terms of BMI, osteoporosis, SHR, surgical time, and postoperative drainage between the two groups. Binary Logistics regression analysis indicated that surgical time, postoperative drainage, and SHR were independent influencing factors for perioperative HBL in hip fracture patients ( p < 0.05). The ROC analysis revealed an area under the curve (AUC) of 0.911, with a standard error of 0.024 (95% CI, 0.865 ~ 0.958) and a Youden index of 0.65. At this threshold, the sensitivity was 71.22%, and the specificity was 94.00%. Patients with SHR < 1.18 had higher EQ-5D scores, Hct, Hb, PLT, and RBC compared to those with SHR ≥ 1.18. Additionally, complications, length of hospital stay, readmission rates, CRP, APTT, and PT were lower in the SHR < 1.18 group, with statistically significant differences ( p < 0.05). Conclusion SHR demonstrates a certain predictive value for perioperative HBL in patients with hip fractures, suggesting its inclusion in evaluation models.