Objective:

To determine the association between the stress hyperglycemia ratio (SHR) at ICU admission and short-term mortality (28-day and 90-day) in adults with sepsis, while assessing the relationship across specific diabetes subgroups such as type 1 and type 2 diabetes.

Key Findings:

• Higher SHR is associated with increased 28-day and 90-day all-cause mortality in septic patients, highlighting the need for careful monitoring.
• The relationship between SHR and mortality is nonlinear, indicating varying risk levels at different SHR values.
• Diabetes status modifies the association between SHR and mortality outcomes, suggesting tailored approaches for different patient groups.

Interpretation:

The SHR serves as a valuable metric for risk stratification in septic patients, highlighting the importance of considering chronic glycemic status in acute care settings and suggesting potential pathways for clinical implementation.

Limitations:

• Retrospective design limits causality inference.
• Potential confounding factors such as comorbidities and treatment variations may not be fully accounted for despite adjustments.

Conclusion:

The study underscores the significance of SHR in predicting short-term mortality in septic patients, suggesting its potential utility in clinical risk assessment.