Low estimated glucose disposal rate (eGDR) predicts decreased all-cause mortality in critically ill patients with cardiorenal syndrome (CRS): analysis of the MIMIC-IV database

Most previous studies on Estimated Glucose Disposal Rate (eGDR) have been conducted in general population, with few studies focusing on critically ill patients. We investigated the predictive value of eGDR in death risk in intensive care unit (ICU) patients with cardiorenal syndrome (CRS). Our study selected ICU patients from the MIMIC-IV database, and we focused on the outcomes of 30-, 90-, 180-, and 360-day mortality. We assessed the predictive value of eGDR for mortality in ICU patients with CRS by multivariate Cox regression models, restricted cubic spline (RCS), and Kaplan-Meier curves. The study included 2,398 participants with a median age of 71.0 years, and 61.2% were male. Multifactorial Cox regression models as well as RCS analysis showed that LOW eGDR was significantly associated with DECREASED 30-day mortality, 90-day mortality, 180-day mortality, and 360-day mortality, and there was a significant nonlinear relationship between eGDR and 90-day mortality, 180-day mortality, and 360-day mortality. This relationship was also found in all critically ill patients. We further stratified the eGDR and found that the significant correlation between eGDR levels and all-cause mortality was mainly present in ICU patients with CRS who were not treated with CRRT. Combined with the results of the Boruta algorithm, higher eGDR is associated with increased all-cause mortality in critically ill patients, including those with crs, and this was particularly evident in patients not treated with CRRT. This surprising result is counter to our hypothesis and may suggest that insulin resistance improves survival.