Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan City, 030001, Shanxi Province, China.
Department of General Medicine, Xuanwu Hospital of Capital Medical University, Beijing, 100053, China.
BMC Infect Dis. 2024 Aug 5;24(1):785. doi: 10.1186/s12879-024-09711-4.
Sepsis is a life-threatening condition that poses a globally high mortality rate. Identifying risk factors is crucial. Insulin resistance and the TYG index, associated with metabolic disorders, may play a role. This study explores their correlation with mortality in non-diabetic septic patients.
This retrospective cohort study used data from the MIMIC-IV (version 2.1) database, which includes over 50,000 ICU admissions from 2008 to 2019 at Beth Israel Deaconess Medical Center in Boston. We included adult patients with sepsis who were admitted to the intensive care unit in the study. The primary outcome was to evaluate the ability of TYG to predict death at 28-day of hospital admission in patients with sepsis.
The study included 2213 patients with sepsis, among whom 549 (24.8%) died within 28 days of hospital admission. We observed a non-linear association between TYG and the risk of mortality. Compared to the reference group (lower TYG subgroup), the 28-day mortality increased in the higher TYG subgroup, with a fully adjusted hazard ratio of 2.68 (95% CI: 2.14 to 3.36). The area under the curve (AUC) for TYG was 67.7%, higher than for triglycerides alone (AUC = 64.1%), blood glucose (AUC = 62.4%), and GCS (AUC = 63.6%), and comparable to SOFA (AUC = 69.3%). The final subgroup analysis showed no significant interaction between TYG and each subgroup except for the COPD subgroup (interaction P-values: 0.076-0.548).
In our study, TYG can be used as an independent predictor for all-cause mortality due to sepsis within 28 days of hospitalization.
脓毒症是一种危及生命的病症，其全球死亡率很高。识别风险因素至关重要。与代谢紊乱相关的胰岛素抵抗和 TYG 指数可能发挥作用。本研究探讨了它们与非糖尿病脓毒症患者死亡率的相关性。
本回顾性队列研究使用了来自波士顿贝斯以色列女执事医疗中心的 MIMIC-IV（版本 2.1）数据库的数据，该数据库包含了 2008 年至 2019 年期间超过 50000 名 ICU 入院患者。我们纳入了患有脓毒症且入住 ICU 的成年患者。主要结局是评估 TYG 在预测脓毒症患者住院 28 天内死亡的能力。
研究纳入了 2213 例脓毒症患者，其中 549 例（24.8%）在住院 28 天内死亡。我们观察到 TYG 与死亡率风险之间存在非线性关联。与参考组（较低的 TYG 亚组）相比，较高的 TYG 亚组 28 天死亡率增加，经完全调整后的危险比为 2.68（95%CI：2.14 至 3.36）。TYG 的曲线下面积（AUC）为 67.7%，高于甘油三酯（AUC=64.1%）、血糖（AUC=62.4%）和 GCS（AUC=63.6%），与 SOFA（AUC=69.3%）相当。最终的亚组分析显示，除 COPD 亚组（交互 P 值：0.076-0.548）外，TYG 与每个亚组之间没有显著的交互作用。
在我们的研究中，TYG 可作为住院后 28 天内脓毒症全因死亡率的独立预测指标。
