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脓毒症重症患者全因死亡率与甘油三酯血糖体重指数之间的关联:一项回顾性队列研究

Association between all-cause mortality and triglyceride glucose body mass index among critically ill patients with sepsis: a retrospective cohort investigation.

作者信息

Jin Huijun, Xu Xuefeng, Ma Chun, Hao Xinghai, Zhang Jinglan

机构信息

Department of Surgical Intensive Care Unit, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.

Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.

出版信息

Lipids Health Dis. 2024 Dec 20;23(1):414. doi: 10.1186/s12944-024-02390-9.

Abstract

BACKGROUND

We determined utilizing a sepsis participant cohort whether there is a significant association between TyG-BMI (triglyceride glucose body mass index) and mortality rates at any stage.

METHODS

Herein, a historical cohort investigation approach was adopted, using information provided by the Medical Information Mart for Intensive Care-IV (MIMIC-IV). We categorized the included individuals in accordance with their TyG-BMI data quartiles, and the primary outcomes were mortality during the hospital stay and death rate due to any reason at postadmission day 28, 90, and 365. To evaluate TyG-BMI mortality's relationship with sepsis-induced mortality risk, we employed restricted cubic spline regression (RCS) and Cox regression models. Additionally, we confirmed TyG-BMI's significant predictive value for mortality via machine learning methods. Furthermore, we performed subgroup analyses to investigate possible differences among various patient groups.

RESULTS

The cohort included 4759 individuals, aged 63.9 ± 15.0 years, involving 2885 males (60.6%). The rates of death that took place during hospital stay and at 28, 90 and 365 days postadmission were respectively 19.60%, 24.70%, 28.80%, and 35.20%. As reflected by Cox models, TyG-BMI was negatively associated with mortality risk at various intervals: in-hospital [hazard ratio (HR) 0.47 (0.39-0.56), P = 0.003], 28 days postadmission [HR 0.42 (0.35-0.49), P < 0.001], 90 days postadmission [HR 0.41 (0.35-0.48), P < 0.001], and 365 days postadmission [HR 0.41 (0.35-0.47), P < 0.001]. Additionally, the relationship between TyG-BMI and death rates was L-shaped, as reflected by the RCS, with a TyG-BMI of 249 being the turning point.

CONCLUSIONS

Among sepsis patients in critical care, TyG-BMI is negatively correlated with mortality possibility at various intervals: during hospital stay and 28 days, 90 days, and one year postadmission. TyG-BMI is a beneficial parameter for categorizing risk levels among sepsis patients and for predicting their mortality risk within one year.

摘要

背景

我们利用脓毒症参与者队列来确定甘油三酯葡萄糖体重指数(TyG-BMI)与任何阶段死亡率之间是否存在显著关联。

方法

在此,采用历史队列研究方法,使用重症监护医学信息数据库-IV(MIMIC-IV)提供的信息。我们根据TyG-BMI数据四分位数对纳入个体进行分类,主要结局是住院期间的死亡率以及入院后第28天、90天和365天因任何原因导致的死亡率。为了评估TyG-BMI与脓毒症诱导的死亡风险之间的关系,我们采用了受限立方样条回归(RCS)和Cox回归模型。此外,我们通过机器学习方法证实了TyG-BMI对死亡率的显著预测价值。此外,我们进行了亚组分析以研究不同患者组之间可能存在的差异。

结果

该队列包括4759名个体,年龄为63.9±15.0岁,其中男性2885名(60.6%)。住院期间以及入院后28天、90天和365天的死亡率分别为19.60%、24.70%、28.80%和35.20%。Cox模型显示,TyG-BMI在不同时间段与死亡风险呈负相关:住院期间[风险比(HR)0.47(0.39 - 0.56),P = 0.003],入院后28天[HR 0.42(0.35 - 0.49),P < 0.001],入院后90天[HR 0.41(0.35 - 0.48),P < 0.001],入院后365天[HR 0.41(0.35 - 0.47),P < 0.001]。此外,RCS显示TyG-BMI与死亡率之间的关系呈L形,转折点的TyG-BMI为249。

结论

在重症监护的脓毒症患者中,TyG-BMI在不同时间段与死亡可能性呈负相关:住院期间以及入院后28天、90天和1年。TyG-BMI是对脓毒症患者进行风险分层以及预测其1年内死亡风险的有益参数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a35/11660890/67ca186c6e6b/12944_2024_2390_Fig1_HTML.jpg

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