The stress hyperglycemia ratio (SHR) is a measure calculated as the initial blood glucose level divided by the estimated mean glucose level from glycated hemoglobin (HbA1c). A systematic review and meta-analysis including 11 retrospective cohort studies with 37,790 participants demonstrated that higher levels of SHR were significantly associated with an increased risk of in-hospital mortality (RR = 2.11), short-term mortality (RR = 1.56), and long-term mortality (RR = 1.52). Subgroup analyzes by length of follow-up (60 days, 90 days, and 1 year) did not reveal statistically significant differences, suggesting that follow-up duration was not a major source of between-study differences. Meta-regression analysis showed that studies with a higher proportion of diabetic patients demonstrated a stronger association between SHR and in-hospital mortality. The researchers concluded that elevated SHR is an independent predictor of all-cause mortality in ICU patients with sepsis. SHR may serve as a simple and valuable prognostic biomarker for early risk stratification in patients with sepsis.