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Predictive value of stress hyperglycaemia ratio for 28-day all-cause mortality in elderly patients with hip fracture: a retrospective single-centre study in Beijing Jishuitan Hospital, Capital Medical University, Beijing, China

Xue Zhan,Hao Wang,Ying Bai

Published 2025 in BMJ Open

ABSTRACT

Objective This study aims to investigate the predictive value of stress hyperglycaemia ratio (SHR) for 28-day all-cause mortality in elderly patients with hip fractures. Design A retrospective study. Setting Beijing Jishuitan Hospital, Capital Medical University. Participants This study included elderly patients with hip fractures treated at our hospital between January and April 2023. Primary and secondary outcome measures The receiver operating characteristic curve analysis and Youden index were employed to ascertain the optimal predictive threshold for SHR and to evaluate its predictive accuracy for 28-day all-cause mortality. Results A total of 443 elderly patients with hip fractures was analysed, with a mean age of 78.11±7.83 years in the survival group and 88±5.48 years in the non-survival group. Deceased patients exhibited higher rates of pulmonary infection, acute coronary syndrome, acute kidney injury, cardiac insufficiency and renal insufficiency than survivors. They also had older age, lower body weight, hypoalbuminaemia, elevated admission glucose, increased N-terminal pro-brain natriuretic peptide and higher SHR. The cohort comprised 121 men (27.3%), and all-cause mortality was observed in 17 patients (3.84%). Multivariate logistic regression analysis showed that SHR (p<0.001, OR=6.944, 95% CI 2.584 to 18.659) was an independent risk factor for 28-day all-cause mortality. The SHR demonstrated an area under the receiver operating characteristic curve of 0.70 for predicting 28-day mortality in elderly patients with hip fractures, with a sensitivity of 64.71% and specificity of 85.68%. Conclusions The SHR is associated with 28-day all-cause mortality in elderly patients with hip fractures, suggesting its potential as a predictive marker for this outcome.

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