时间标签：数据日期 2026-11-05 · 生成时间 2026-11-05 05:30（Asia/Shanghai）｜ 检索窗口 PubMed edat 2026/11/02 – 2026/11/06 ｜ 情报发生日期 2026-11-05
研究问题
While other metabolic indices (e.g., the Triglyceride-Glucose[TyG] index) have been linked to neurological outcomes [20], the specific utility of SHR—a metric designed to gauge acute metabolic stress—for predicting POD risk in elderly cardiac surgery patients admitted to the ICU remains unexplored.Therefore, we hypothesize that SHR serves as an independent predictor of POD during ICU stay in this high-risk population.；Our findings may provide a novel, objective, and readily accessible metabolic perspective for risk stratification, facilitating early identification and targeted interventions.MethodsData sources and study designThis multicenter retrospective cohort study utilized two independent data sources.；We acknowledge that interventional trials are needed to confirm whether SHR-guided strategies improve outcomes.The nonlinear, threshold-dependent association we identified between SHR and POD diverges from prior reports of linear relationships [38].
方法
In elderly patients undergoing cardiac surgery, POD is highly prevalent (reported incidence: 2.9%–54.9%) and is associated with prolonged hospitalization, increased healthcare costs, long-term cognitive decline, and higher mortality [2–7].；However, interpreting blood glucose in elderly cardiac surgery patients is confounded by chronic conditions and medications.；While other metabolic indices (e.g., the Triglyceride-Glucose[TyG] index) have been linked to neurological outcomes [20], the specific utility of SHR—a metric designed to gauge acute metabolic stress—for predicting POD risk in elderly cardiac surgery patients admitted to the ICU remains unexplored.Therefore, we hypothesize that SHR serves as an independent predictor of POD during ICU stay in this high-risk population.
核心结论
This postoperative period after cardiac surgery is marked by a biphasic metabolic crisis—transitioning from hypometabolism to sustained hypermetabolism—with features of insulin resistance, rampant inflammation, and oxidative stress, which collectively form a central mechanistic substrate for POD development in this vulnerable population [8, 9, 12].Within this pathophysiological context, stress-induced hyperglycemia emerges as a key measurable manifestation of systemic metabolic dysregulation.；RCS analysis demonstrated a significant nonlinear relationship between SHR and POD risk, with an identifiable inflection point at SHR = 1.09 (P for nonlinearity < 0.05; Fig. 3).；First, sensitivity analyses using SHR quartiles in Model 3 demonstrated a graded dose–response relationship: adjusted ORs for Q2–Q4 (vs.
局限
A critical limitation of these models is their inability to capture the severe metabolic and inflammatory disturbances that define the perioperative period, particularly in the intensive care unit (ICU) [11].；However, interpreting blood glucose in elderly cardiac surgery patients is confounded by chronic conditions and medications.；However, the sample sizes achieved in this study (discovery cohort, n = 1,087; validation cohort, n = 982) represent the maximum feasible sample obtainable from the existing high-quality MIMIC-IV database and the multicenter clinical dataset.
对本项目的价值
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全文来源
PubMed PMC JATS（正文 46,608 字符，题名指纹 1.0，已过 PubMed PMCID 官方关联 + 题名指纹 + 正文长度归属校验）
原文题录
- 中文题名：应激高血糖比值与老年心脏术后 ICU 谵妄相关：多中心回顾性队列研究
- 英文标题：Stress hyperglycemia ratio is associated with delirium in elderly cardiac surgery patients in the postoperative intensive care unit: a multicenter retrospective cohort study.
- 期刊与标识：BMC geriatrics · PMID 42972259 · DOI 10.1186/s12877-026-08083-5 · PMC PMC13729561