Correlation Between Stress Hyperglycemia Ratio SHR And Prognosis Of ANYUGIB Patients

Objective: To compare the ratio of stress hyperglycemia with GBS score and Pre-Rockall score system,and to explore the value of stress hyperglycemia ratio SHR in evaluating the prognosis of acute non-varicose upper gastrointestinal bleeding.Methods: The clinical data of patients diagnosed with acute non-varicose upper gastrointestinal bleeding admitted to Yijishan Hospital of Wannan Medical College(Grade III A general Hospital)from August 1,2019 to August 1,2022 were retrospectively collected,and the clinical manifestations,vital signs,laboratory examination data,and underlying diseases of the patients at admission were recorded.The data included gender,age,length of stay,temperature,pulse,heart rate,systolic blood pressure,blood glucose upon admission,hemoglobin a1 C,hemoglobin,blood urea nitrogen and other clinical indicators within 24 hours of admission.GBS score and Pre-Rockall score were performed within 24 hours and SHR was calculated.Gastroscopy was performed within 3 days to determine the cause of the disease.All data were analyzed using IBM SPSS26.0 and Med Cal software.Regression analysis was used to evaluate the relationship between relevant indicators and clinical prognosis.Receiver operating characteristic(ROC)curve analysis was performed.SHE was compared with GBS and Rockall scoring system to evaluate their prognostic value for acute non-varicose upper gastrointestinal bleeding.Results: Among the 104 patients,there were 70 male patients and 34 female patients.After 28-day follow-up,none of the patients died,and part of the patients suffered from rebleeding within 28 days.Therefore,the grouping of the study was based on whether the patients suffered from rebleeding within 28 days,and the patients without rebleeding within 28 days were taken as the group with good prognosis.Patients with rebleeding within 28 days were selected as the poor prognosis group,including 34 patients with good prognosis and 70 patients with poor prognosis.The median age of patients in the good prognosis group was 52 years old,and the median age of patients in the poor prognosis group was 68 years old.The cause of bleeding was confirmed in all patients by endoscopic diagnosis,including 53 cases(51%)of gastric ulcer,accounting for the highest proportion,followed by 40 cases(38.5%)of duodenal bulbar ulcer,6cases(5.8%)of complex ulcer,5 cases(4.8%)of gastric malignant tumor,4 cases(3.8%)of acute erosive hemorrhagic gastritis,the lowest proportion.Duodenal bulbar ulcer was the highest cause of hemorrhage in the good prognosis group(27 cases(79%),while gastric ulcer was the highest cause of hemorrhage in the poor prognosis group(46 cases(66%).According to the analysis of the basic information of the patients,there were statistically significant differences between the two groups in age,length of hospital stay,cause of bleeding,systolic blood pressure and other clinical indicators(P < 0.05),while there were no statistically significant differences in gender,body temperature,pulse,respiratory rate and other indicators(P > 0.05).In the comparative analysis of laboratory test indicators and related scores,there were statistically significant differences between the two groups in clinical indicators such as hemoglobin,blood urea nitrogen,blood glucose on admission,SHR,GBS score and Pre-Rockall score(P < 0.05).The Peason correlation study of SHR and GBS score and Pre-Rockall score for all patients has been conducted,and the results of Peas ON score has increased with the increase of SHR value,showing a significant positive correlation between the two(r=0.489,P < 0.001).There was also a significant positive correlation between SHR and Pre-Rockall score(r=0.324,P < 0.001).The area under ROC curve of SHR,GBS score and Pre-Rockall score for predicting the prognosis of acute non-varicose upper gastrointestinal bleeding was 0.804(0.710-0.897),0.973(0.949-0.997)and 0.785(0.693-0.877),respectively.The sensitivity was 0.771,0.900 and 0.886,and the specificity was 0.794,0.941 and0.559,respectively.Among the three,GBS score had the highest prognostic value,followed by SHR score,and Pre-Rockall score had the lowest prognostic value.Conclusion:1.SHR,GBS score and Pre-Rockall score all have certain value in predicting the accuracy of ANYUGIB prognosis.2.As an indicator to predict the prognosis of ANYUGIB patients,SHR has a fair specificity but insufficient sensitivity,and medium overall predictive value.3.GBS score has the highest specificity and sensitivity in predicting the prognosis of ANYUGIB,and the best overall prediction value.4.The sensitivity of Pre-Rockall score in predicting the prognosis of ANYUGIB is reasonable,but the specificity is insufficient,and the overall prediction value is low.