Risk Factors and Predictive Model for Stress Hyperglycemia After Cardiac Surgery in Non-Diabetic Patients

Mengli Zhang,1,* Jinyan Wu,1,* Lulu Wang,2 Hui Huang,2 Huan Duan,3 Fang Xue1 1School of Nursing, Bengbu Medical University, Bengbu, Anhui, People’s Republic of China; 2Cardiac Surgery, The First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui, People’s Republic of China; 3Intensive Care Unit, The First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui, People’s Republic of China*These authors contributed equally to this workCorrespondence: Fang Xue, School of Nursing, Bengbu Medical University, Bengbu, Anhui, 233030, People’s Republic of China, Email [email protected] Huan Duan, Intensive Care Unit, The First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui, People’s Republic of China, Email [email protected]: To create and verify a model that predicts the risk of stress hyperglycemia (SHG) in patients without diabetes after cardiac surgery.Design: Retrospective analysis.Methods: This retrospective analysis analyzed patients without diabetes post cardiac surgery at our hospital between June 2020 and December 2023. The 333 patients from June 2020 to June 2022 constituted the developmental sample and the 162 patients from July 2022 to December 2023 constituted the testing sample.Results: Of 495 patients, 356 (71.9%) developed SHG. Multivariable analysis identified hyperlipidemia, coronary artery bypass grafting (CABG), hypertension, blood transfusion, body mass index (BMI) ≥ 28 kg/m², and hyperoxia during cardiopulmonary bypass (PaO2≥ 300mmHg) as significant factors influencing SHG in patients without diabetes after cardiac surgery. The goodness-of-fit test for the risk prediction model based on these factors showed X² = 0.85, P = 0.588. The area under the receiver operating characteristic curve (AUC) for the modeling group was 0.85, with a maximum Youden index of 0.579, an optimal cutoff value of 0.637, a sensitivity of 83.4%, and a specificity of 74.5%. For the external validation group, the AUC was 0.805, with a Youden index of 0.704, 82.6% sensitivity, and 87.8% specificity, and a diagnostic value of 0.839.Conclusion: Hyperlipidemia, CABG, hypertension, blood transfusion, BMI ≥ 28 kg/m², and hyperoxia during CPB (PaCO2≥ 300mmHg) are significant risk factors for SHG in patients without diabetes following cardiac surgery. The model constructed based on these factors can effectively predict the risk of SHG, providing a basis for early intervention measures reduce the incidence of this condition.Keywords: cardiac surgery, stress hyperglycemia, SHG, contributing factors, risk prediction model, nursing, R software