ArticleCardiovascular diabetology2025
Prognostic value of triglyceride-glucose index combined with stress hyperglycemia ratio for all-cause mortality in critically ill patients with stroke.
Article in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed.
- Association of the triglyceride-glucose index with one-year all-cause mortality in patients with spontaneous basal ganglia hemorrhage: a retrospective study.BMC neurology · 2026Article
- Combined assessment of triglyceride-glucose index and stress hyperglycemia ratio to predict all-cause mortality in critically ill patients with intracerebral hemorrhage.BMC neurology · 2026Article
- Association of longitudinal changes in depressive symptoms and handgrip strength with cardiovascular disease in middle-aged and elderly populations.BMC public health · 2026Article
- Association between triglyceride-glucose index and vascular dementia in ICU patients with cerebrovascular disease: a retrospective study based on the MIMIC-IV database.BMC neurology · 2026Article
- Target trial emulation of early acetaminophen use and mortality in critically ill stroke patients.Scientific reports · 2026Article
- Association between stress hyperglycemia ratio and all-cause mortality in neurocritical patients.Scientific reports · 2026Article
- The prognostic value of the PALBI score for mortality prediction in stroke: an internal and external validation study.Scientific reports · 2026Article
- Association of atherogenic index of plasma and cardiometabolic index with all-cause mortality and cardiovascular disease in NAFLD patients: NHANES 1999-2018.Cardiovascular diabetology · 2026Article
- Association between stress hyperglycemia ratio and early neurological deterioration after acute ischemic stroke: a retrospective cohort study.BMC neurology · 2026Article
- Cumulative average remnant cholesterol inflammatory index and risk of cardiometabolic multimorbidity: evidence from a prospective nationwide cohort study in China.Lipids in health and disease · 2026Article
- Systemic immune-inflammation index, stress hyperglycemia ratio and triglyceride-glucose index in acute ischemic stroke: an integrated inflammation-stress-metabolism perspective.Frontiers in neurology · 2026Review
- Dynamic TyG trajectories cumulative TyG burden are associated with in-hospital mortality in acute brain injury: a multicenter interpretable machine-learning analysis.Frontiers in nutrition · 2026Article
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Abstract
backgroundThe triglyceride-glucose (TyG) index and stress hyperglycemia ratio (SHR) are emerging biomarkers in cerebrovascular diseases, but their combined prognostic value for mortality in patients with critically ill stroke remains unexplored. This study, based on a cohort of critically ill patients with stroke, aims to investigate the prognostic value of the combined TyG index and SHR in predicting all-cause mortality at multiple time points in this high-risk population.
methodsBased on the Medical Information Mart for Intensive Care (MIMIC)-IV database, 2998 critically ill patients with stroke requiring intensive care unit (ICU) admission were included. Patients were stratified into 8 groups based on the median of the TyG index and the quartiles of the SHR. The primary outcomes were 30-day and 365-day all-cause mortality; the secondary outcomes included 90-day and 180-day mortality. Cox proportional hazards regression models, restricted cubic splines (RCS) curves, subgroup analyses, and mediation analyses were employed to assess associations between the combined TyG index and SHR with all-cause mortality.
resultsThe cohort had a median age of 72.63 years (IQR 61.27-82.69 years), with 51.33% male (1539/2998). Fully adjusted Cox proportional hazards models showed that compared to the reference group (TyG < 8.72 and SHR < 0.86), patients with TyG ≥ 8.72 and SHR ≥ 1.18 had the highest mortality risk (30-day HR 2.481, 95% CI 1.767-3.485; 365-day HR 1.954, 95% CI 1.532-2.493). RCS analysis confirmed linear positive correlations between the TyG index, SHR, and mortality at all time points (all P for non-linearity > 0.05). Subgroup analyses further demonstrated consistent associations between the combined TyG index and SHR on 30-day and 365-day all-cause mortality. Mediation analysis revealed that the highest SHR significantly mediated the association between high TyG and mortality in these patients (30-day mediation proportion: 48.82%, P = 0.024; 365-day: 22.93%, P = 0.004).
conclusionThe combination of high TyG (≥ 8.72) and elevated SHR (≥ 1.18) is significantly associated with increased short- and long-term mortality in critically ill patients with stroke. Integrated metabolic monitoring and early intervention targeting at these biomarkers may improve their prognosis.
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