Department of Anesthesiology and Surgical Intensive Care Unit, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Anesthesiology, The affiliated Hospital of Qingdao University, Qingdao, China.
Adipocyte. 2024 Dec;13(1):2379867. doi: 10.1080/21623945.2024.2379867. Epub 2024 Jul 16.
Sepsis is a significant contributor to both intensive care unit (ICU) admissions and mortality among patients in ICU, with a rising prevalence of obesity. There is a lack of extensive research on the correlation between TyGI and findings in patients with sepsis, especially in obese patients.
This study used a retrospective cohort design and included patients with sepsis (≥18 years) from the Medical Information Mart for Intensive Care IV database. The association between TyGI and outcome was examined using multivariable logistic regression analysis.
8,840 patients with sepsis were included in the analysis. The in-ICU mortality rate was 9.7%. Non-survivors exhibited significantly greater TyGI levels than survivors [9.19(8.76-9.71) vs. 9.10(8.67-9.54), < 0.001]. The adjusted multivariate regression model showed that elevated TyGI values were linked to a greater likelihood of death in ICU (odds ratio [OR] range 1.072-1.793, < 0.001) and hospital (OR range 1.068-1.445, = 0.005). Restricted Cubic Spline analysis revealed a nonlinear association between TyGI and in-ICU and in-hospital mortality risks within specified ranges. Subgroup analysis revealed interaction effects in the general obesity, abdominal obesity, and impaired fasting glucose subgroups ( = 0.014, 0.016, and < 0.001, respectively).
TyGI was associated with an increased sepsis-related short-term mortality risk and adverse outcomes after ICU admission.
脓毒症是导致重症监护病房（ICU）患者入院和死亡的重要原因之一，而肥胖的患病率也在不断上升。目前，关于 TyGI 与脓毒症患者检查结果之间的相关性研究还不够广泛，特别是在肥胖患者中。
本研究采用回顾性队列设计，纳入了来自医疗信息集市重症监护 IV 数据库的脓毒症（≥18 岁）患者。使用多变量逻辑回归分析来检验 TyGI 与结局之间的关联。
本研究共纳入了 8840 例脓毒症患者。ICU 死亡率为 9.7%。非幸存者的 TyGI 水平明显高于幸存者[9.19（8.76-9.71）比 9.10（8.67-9.54）， < 0.001]。调整后的多元回归模型显示，升高的 TyGI 值与 ICU 内死亡的可能性增加相关（比值比 [OR] 范围 1.072-1.793， < 0.001）和住院（OR 范围 1.068-1.445， = 0.005）。受限立方样条分析显示，在特定范围内，TyGI 与 ICU 内和住院内死亡率风险之间存在非线性关联。亚组分析显示，在一般肥胖、腹部肥胖和空腹血糖受损亚组中存在交互作用效应（ = 0.014、0.016 和 < 0.001）。
TyGI 与脓毒症相关的短期死亡风险增加和 ICU 入院后的不良结局相关。
