Higher Stress Hyperglycemia Ratio Is Associated With a Higher Risk of Stroke-Associated Pneumonia

Jiejie Tao; Zhishan Hu; Feiling Lou; Junxin Wu; Zijing Wu; Shuang Yang; Xiaofang Jiang; Meihao Wang; Qiqi Huang; Wenwei Ren

doi:10.3389/fnut.2022.784114

Higher Stress Hyperglycemia Ratio Is Associated With a Higher Risk of Stroke-Associated Pneumonia

Front Nutr. 2022 Feb 22:9:784114. doi: 10.3389/fnut.2022.784114. eCollection 2022.

Authors

Jiejie Tao¹, Zhishan Hu², Feiling Lou¹, Junxin Wu³, Zijing Wu³, Shuang Yang³, Xiaofang Jiang⁴, Meihao Wang¹, Qiqi Huang⁵, Wenwei Ren⁴

Affiliations

¹ Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
² State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.
³ School of Mental Health, Wenzhou Medical University, Wenzhou, China.
⁴ Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
⁵ Department of Cardiac Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

Abstract

Objective: Stroke-associated pneumonia (SAP) is a frequent complication in stroke patients. This present study aimed to investigate the association between stress hyperglycemia and SAP.

Methods: Patients were screened between February 2013 and August 2020 from the First Affiliated Hospital of Wenzhou Medical University. We divided the blood glucose of the patients at admission by the glycated hemoglobin to calculate the stress hyperglycemia ratio (SHR). Binary logistic regression analysis was used to identify the association between SAP and SHR, with the confounders being controlled. Further, subgroup analyses were separately performed for stroke patients with and without diabetes.

Results: A total of 2,039 patients were finally recruited, of which 533 (26.14%) were diagnosed with SAP. SHR were divided into four quartiles in the logistic regression analysis, the highest SHR quartile (SHR ≥ 1.15) indicated a higher risk of SAP (OR = 1.57; 95% CI = 1.13-2.19, p = 0.01) in total patients. In patients without diabetes, the third quantile (SHR = 0.96-1.14) and the highest quantile (SHR ≥ 1.15) were both related to a higher risk of SAP (both p < 0.05). However, we did not find such an association in diabetic patients.

Conclusion: SHR was significantly associated with the risk of SAP in patients without diabetes. Adequate attention should be paid to the patients with high SHR levels at admission, especially those without diabetes.

Keywords: diabetes; glucose; pneumonia; stress hyperglycemia; stroke.