Association between the glucose-to-albumin ratio and short-term in-hospital mortality in critically ill patients with premature acute myocardial infarction: A retrospective study from the eICU-CRD
Yuanxi Lu, Xin Lin, Lijing Liu, Xin Wen, Qiwu Wang
Premature acute myocardial infarction (PAMI) is a high-risk condition among critically ill patients, accompanied by metabolic and inflammatory disturbances. The glucose-to-albumin ratio (GAR) reflects both stress hyperglycemia and nutritional-inflammatory status, but evidence regarding its prognostic relevance in critically ill patients with PAMI remains limited. This study aimed to investigate the prognostic value of GAR for short-term in-hospital mortality in this population. We conducted a retrospective cohort study using data from the eICU Collaborative Research Database. Patients with PAMI were divided into 2 groups according to the X-tile-derived exploratory cutoff of 5.80. Cox proportional hazards regression models were constructed with stepwise adjustment for potential confounders to assess the association between GAR and 28-day in-hospital mortality. Restricted cubic spline analysis was used to evaluate the dose–response relationship between GAR and mortality. Kaplan–Meier survival curves were generated to compare survival between groups, and subgroup and interaction analyses were performed across major clinical strata. Receiver operating characteristic curve analysis was used to assess the exploratory discriminatory ability and adjunctive prognostic information of GAR. A total of 622 patients with PAMI were included. Patients in the high GAR group (>5.80) had a higher 28-day in-hospital mortality rate than those in the low GAR group (≤5.80; 11.9% vs 1.6%). In fully adjusted Cox regression models, each 1-unit increase in GAR was associated with an increased risk of 28-day in-hospital mortality (hazard ratio 1.19, 95% confidence interval 1.07–1.33;