Triglyceride-glucose index linked to all-cause mortality in critically ill patients: a cohort of 3026 patients

Abstract

Background Triglyceride-glucose (TyG) index as a reliable surrogate of insulin resistance (IR) has been shown to be related to adverse clinical outcomes in patients with acute coronary syndrome, heart failure, ischemic stroke and so on. However, the relationship between TyG index and all-cause mortality in intensive care unit (ICU) patients remains unknown. The purpose of this study was to investigate the correlation between TyG index and all-cause mortality to evaluate the impact of IR on the prognosis of this population. Methods This was a retrospective observational study that included 3026 patients who had an initial triglyceride and glucose data on the first day of ICU admission, and all data were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database. These patients were grouped into quartiles (Q1–Q4) according to TyG index. The Kaplan–Meier analysis was used to compare all-cause mortality among the above four groups. Cox proportional hazards analyses were performed to examine the association between TyG index and all-cause mortality. Results During 10.46 years of follow-up, 1148 (37.9%) patients died, of which 350 (11.6%) occurred during the hospital stay and 258 (8.5%) occurred during the ICU stay. Kaplan–Meier analysis showed that the risk of all-cause mortality was significantly higher in patients with higher TyG index (log-rank P = 0.021). Multivariable Cox proportional hazards analyses showed that the TyG index was an independent risk predictor of ICU death (HR: 1.72, 95% CI 1.18–2.52, P = 0.005) and hospital death (HR: 2.19, 95% CI 1.59–3.03, P < 0.001), and each 1-unit increased in the TyG index, a 1.19-fold increase in the risk of death during the hospital stay. Conclusions TyG index is strongly related to the all-cause mortality increasing in critically ill patients. This finding indicates that the TyG index might be useful in identifying people at high risk of ICU death and hospital death.

Association between the triglyceride glucose index and in-hospital and 1-year mortality in patients with chronic kidney disease and coronary artery disease in the intensive care unit

“…According to a retrospective observational study [ 19 ], the TyG score and ICU mortality among critical stroke patients showed a substantial connection and predictive value. Another study [ 20 ] examining the relationship between the TyG index and ICU mortality in critically sick patients also produced similar findings. Nevertheless, there are few data to support relationships between the TyG index and patients' risk of mortality from both CKD and CAD.…”

Relationship between stress hyperglycemia ratio and allcause mortality in critically ill patients: Results from the MIMIC-IV database

“…Moreover, SHR had an incremental effect on the predictive value of various illness scores in predicting ICU all-cause mortality. These illness scores have been demonstrated to have a predictive value in predicting adverse outcomes in ICU patients ( 26 – 29 ). Considering that SHR is essential to the prognosis of ICU patients and is an easily available, reliable, and inexpensive test, we innovatively added SHR to various illness scores and found the predictive value for ICU all-cause death was significantly improved.…”

Independent effects of the triglyceride-glucose index on all-cause mortality in critically ill patients with coronary heart disease: analysis of the MIMIC-III database

“…Structured Query Language (SQL) with PostgreSQL (version 9.6) was used to extract baseline characteristics, including sex, age, body mass index (BMI), and severity at admission (as measured by the Sequential Organ Failure Assessment (SOFA) score, Systemic inflammatory response syndrome (SIRS) score, Acute physiology score III (APSIII), Simplified acute physiological score II (SAPSII)), comorbidities, and laboratory variables within the first 24 h after ICU admission from the MIMIC-III database. The TyG index was calculated as ln [fasting TG (mg/dl) × fasting glucose (mg/dl)]/2 [12,13]. CHD, heart failure, hypertension, atrial fibrillation, dyslipidemia, diabetes, respiratory failure, acute kidney injury (AKI), chronic kidney disease (CKD), and acute myocardial infarction (AMI) were defined with ICD-9 codes.…”