Evidence mapPaperPMID 42378162Full record

ArticleScience progress

Prognostic value of the triglyceride-glucose index combined with glycemic variability for all-cause mortality in patients with sepsis: A retrospective cohort study.

Ao Wang, Yuechen Fu, Ran Li, Yiwen Wang, Mengmeng Zhuang, Qing Xu, Luqi Qiao, Jiayi Cao, Kehui Li, Simiao Chen and 5 more

Abstract read
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Article in Science progress. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Ao WangDepartment of Burn Surgery, The Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Yuechen FuDepartment of Burn Surgery, The Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Ran LiDepartment of Burn Surgery, The Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Yiwen WangDepartment of Burn Surgery, The Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Mengmeng ZhuangDepartment of Burn Surgery, The Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Qing XuDepartment of Burn Surgery, The Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Luqi QiaoDepartment of Burn Surgery, The Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Jiayi CaoDepartment of Burn Surgery, The Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Kehui LiDepartment of Burn Surgery, The Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Simiao ChenDepartment of Burn Surgery, The Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Chao MengDepartment of Burn Surgery, The Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Qian HongDepartment of Burn Surgery, The Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Wendi ChenDepartment of Burn Surgery, The Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Wensheng WangDepartment of Burn Surgery, The Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Yong SunDepartment of Burn Surgery, The Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.ORCID 0000-0001-5720-2779

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

ObjectiveThis study aimed to evaluate the predictive value of the combined triglyceride-glucose index (TyG) and glycemic variability (GV) for all-cause mortality in critically ill patients with sepsis.MethodsThis retrospective cohort study used MIMIC-IV v3.1 as the development cohort and the temporally independent MIMIC-III CareVue subset as the validation cohort. Patients were divided into six groups based on the median TyG index (9.34) and GV tertiles (≤20.54, 20.54-28.11, and >28.11). The primary outcome was 90-day all-cause mortality. Analyses were performed using Kaplan-Meier survival curves, Cox proportional hazards models, and restricted cubic splines, supplemented with subgroup analyses and external validation.ResultsThis study included 1792 patients from MIMIC-IV and 947 patients from the MIMIC-III CareVue subset. In the fully adjusted Cox proportional hazards model, the G6 group (TyG > 9.34 and GV > 28.11) exhibited the highest 90-day all-cause mortality risk compared with the G1 group (TyG ≤ 9.34 and GV ≤ 20.54) (HR = 2.366, 95% CI: 1.595-3.509). The absolute 90-day mortality rate increased from 10.3% in G1 to 27.2% in G6. Kaplan-Meier analysis revealed significant differences in cumulative mortality across the TyG-GV risk groups during the 90-day follow-up (log-rank P < 0.001), with the lowest survival rate observed in G6. The combined TyG and GV model showed a modest but statistically significant improvement in discrimination compared with the baseline model for 90-day mortality, with the AUC increasing from 0.730 (95% CI, 0.700-0.760) to 0.743 (95% CI, 0.714-0.773) (ΔAUC = 0.013, P = 0.048). The continuous net reclassification improvement (cfNRI) and integrated discrimination improvement (IDI) further supported the incremental value of TyG and GV added to the baseline model. Subgroup analyses showed generally consistent directions of association without significant interactions, and external validation supported the robustness of these findings.ConclusionsThe combined phenotype of elevated TyG index (>9.34) and elevated GV (>28.11) was associated with increased short- and long-term all-cause mortality risks and provided supplementary prognostic information in critically ill patients with sepsis; prospective validation is needed.

Indexed as

Blood GlucoseSepsisTriglyceridesAgedCritical IllnessFemaleHumansKaplan-Meier EstimateMaleMiddle AgedPrognosisProportional Hazards ModelsRetrospective StudiesBlood GlucoseTriglyceridesall-cause mortalityglycemic variabilityMIMIC-IIIMIMIC-IVsepsistriglyceride-glucose index

Identifiers

PMID42378162
PMCPMC13319978

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.