Abstract
The Stress Hyperglycemia Ratio (SHR) has emerged as a prognostic indicator associated with adverse outcomes in a variety of diseases. Nevertheless, the relationship between SHR and the prognosis of individuals with chronic obstructive pulmonary disease (COPD) has yet to be clarified. This research examines the association between SHR and outcomes in COPD patients. This study employed the Medical Information Mart for Intensive Care (MIMIC-IV) database to identify patients with COPD requiring admission to the intensive care unit, categorizing them into quartiles according to SHR levels. The outcomes assessed encompassed in-hospital mortality and ICU mortality. The analysis utilized Cox proportional hazards regression, enhanced by restricted cubic splines, to explore the association between SHR and the clinical manifestations present in patients diagnosed with COPD. The study included 1157 COPD patients. The mortality rates were 10.11% for in-hospital, and 7.09% for ICU, respectively. The analysis of Kaplan-Meier (K-M) curves revealed a noteworthy correlation between elevated SHR levels and an augmented risk of mortality in both hospital and ICU environments. Patients with COPD who were in the highest SHR index quartile were at the highest risk of dying, according to a Cox proportional hazards regression analysis (hospital, HR: 1.88,95%CI:1.09-3.25, P = 0.002; ICU: HR: 3.64, 95%CI:1.79-7.42, P < 0.001). Restricted cubic spline (RCS) analysis revealed a U-shaped association between the SHR index and both in-hospital and ICU mortality rates. Elevated SHR levels in COPD patients are significantly linked to a higher mortality risk in both hospitalized and ICU settings. The SHR index serves as a valuable tool for assessing in-hospital outcomes in COPD patients and holds potential to aid in screening high mortality risk COPD patients.