Correlation between the triglyceride-glucose index and all-cause mortality in patients with nondiabetic critical ischemic stroke: an analysis of the MIMIC-Ⅳ database
10.3760/cma.j.issn.1673-4165.2024.12.005
- VernacularTitle:甘油三酯葡萄糖指数与非糖尿病危重缺血性卒中患者全因死亡的关系：对MIMIC-Ⅳ数据库的分析
- Author:
Haoming ZHANG
1
;
Zhen LIU
;
Feng HE
;
Tieyu TANG
Author Information
1. 扬州大学附属医院神经内科，扬州 225001
- Keywords:
Ischemic stroke;
Critical illness;
Mortality;
Triglycerides;
Blood glucose;
Insulin resistance;
Risk factors;
Biomarkers
- From:
International Journal of Cerebrovascular Diseases
2024;32(12):906-915
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the correlation between the triglyceride-glucose index (TyG) and all-cause mortality (ACM) in patients with nondiabetic critical ischemic stroke (IS).Methods:Patient data in Medical Information Mart for Intensive CareⅣ (MIMIC-Ⅳ) database version 3.1 were retrieved retrospectively. According to the quartiles of TyG index, they were divided into four groups ( Q1, Q2, Q3, and Q4). Kaplan-Meier survival analysis was used to compare ACM at different periods (30 days, 90 days, 180 days, and 1 year). The correlation between the TyG index and endpoint events was examined through restrictive cubic spline plot, Cox proportional hazards regression model, subgroup analysis, and sensitivity analysis. Results:A total of 1 491 patients (49% male) were included, with ACM of 18%, 22%, 25%, and 27% at 30 days, 90 days, 180 days, and 1 year, respectively. Kaplan-Meier survival analysis showed that the risk of death was significantly increased in the TyG index Q4 group. The restricted cubic spline plot showed a linear relationship between the TyG index and ACM. Multivariate Cox proportional hazards regression analysis suggests that the increase of TyG index was significantly correlated with the increase of ACM risk. Compared with the Q1 group, after adjusting for various confounding factors, the hazard ratios (95% confidence intervals) of ACM at 30 days, 90 days, 180 days, and 1 year in the Q4 group were 2.35 (1.64-3.37), 2.29 (1.67-3.14), 2.19 (1.62-2.95), and 2.11 (1.59-2.81), respectively. Subgroup analysis showed that the correlation between the TyG index and ACM was more significant in patients without hypertension and those who did not use antiplatelet drugs. The sensitivity analysis conducted by the multivariate logistic regression model showed that its trend and statistical significance were basically consistent with the results of Cox proportional hazards regression analysis. Conclusion:The TyG index is significantly correlated with the ACM of patients with nondiabetic critical IS, which may become a valuable and simple predictive markers for such patients.
