Association between glucose‑potassium ratio and all-cause mortality in patients with cardiogenic shock: a retrospective study

Background: The glucose‑potassium ratio (GPR) reflects metabolic disturbances and electrolyte imbalances. Several studies have confirmed that GPR is associated with prognosis in a variety of cardiovascular and cerebrovascular diseases. The aim of this study was to investigate the association between GPR and all-cause mortality in cardiogenic shock (CS) patients. Methods: In this study, patients with CS who were admitted to the ICU for the first time were extracted from the Medical Information Mart for Intensive Care (MIMIC-IV) database. The patients were then categorized into five groups based on GPR. The outcomes included 30-day and 120-day all-cause mortality. Cox proportional risk regression and restricted cubic spline were used to analyze GPR association with all-cause mortality. Results: A total of 1397 patients with CS were included in this study. Multifactorial Cox proportional risk analysis showed that elevated GPR was significantly associated with 30- and 120-day all-cause mortality. The restricted cubic spline showed a J-shaped relationship between GPR and all-cause mortality with an inflection point of 2.081. Patients with a higher GPR had an 18.7% increased risk of 30-day all-cause mortality [Hazard ratio (HR): 1.187, 95% (Confidence interval) CI: 1.098-1.284] and a 17.9% increased risk of 120-day all-cause mortality (HR: 1.179, 95% CI: 1.112-1.250) compared with patients with a GPR below the inflection point. Conclusions: In patients with CS, higher GPR was significantly associated with increased 30- and 120-day all-cause mortality. The GPR can be an important reference index for severity assessment of CS patients and decision making in clinical practice. Clinical trial number: Not applicable.