Abstract / Summary
Background: The hemoglobin glycation index (HGI) has been introduced to reflect discrepancies between chronic baseline glucose and acute stress-induced glucose changes. HGI has been linked to neurological recovery and poor prognosis among stroke patients. However, its role in poststroke delirium (PSD) remains to be clarified. This study aimed to evaluate the association between HGI levels and the risk of PSD during intensive care unit (ICU) stay in stroke patients.
Methods: Patient data were extracted from MIMIC-IV v3.1. HGI was derived using linear regression analysis based on the relationship between HbA1c levels and fasting plasma glucose (FPG) concentrations. Logistic regression analysis was used to assess the association between HGI and the risk of PSD during ICU stay. The restricted cubic spline (RCS) method was applied to investigate possible nonlinear relationships. Subgroup and interaction analyses were performed to evaluate the robustness of the results.
Results: A total of 2247 patients were included. Of these individuals, 707 developed PSD during ICU stay. Logistic regression indicated that a low HGI value was significantly associated with an elevated risk of PSD. RCS analysis suggested a nonlinear association. The inflection point was identified at HGI = -0.11. For HGI values ≤ -0.11, a one-unit increase in HGI corresponded to a 30.9% lower risk of PSD (OR = 0.691, 95% CI: 0.554-0.859, p < 0.001).
Conclusions: Lower HGI levels were significantly associated with an elevated risk of PSD during ICU stay among severely ill stroke patients. HGI may be a valuable indicator for detecting patients at high risk of PSD.