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Triglyceride-Glucose Index Linked to Hospital Mortality in Critically Ill Stroke: An Observational Multicentre Study on eICU Database

Objective: The triglyceride-glucose (TyG) index is a reliable surrogate of insulin resistance and a marker for ischemic stroke (IS) incident. Whether the TyG index predicts stroke outcome remains uncertain. This study investigated the prognostic value of the TyG index in critically ill stroke patien...

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Autores principales: Zhang, Bingjun, Liu, Lingling, Ruan, Hengfang, Zhu, Qiang, Yu, Dafan, Yang, Yu, Men, Xuejiao, Lu, Zhengqi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7655911/
https://www.ncbi.nlm.nih.gov/pubmed/33195355
http://dx.doi.org/10.3389/fmed.2020.591036
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author Zhang, Bingjun
Liu, Lingling
Ruan, Hengfang
Zhu, Qiang
Yu, Dafan
Yang, Yu
Men, Xuejiao
Lu, Zhengqi
author_facet Zhang, Bingjun
Liu, Lingling
Ruan, Hengfang
Zhu, Qiang
Yu, Dafan
Yang, Yu
Men, Xuejiao
Lu, Zhengqi
author_sort Zhang, Bingjun
collection PubMed
description Objective: The triglyceride-glucose (TyG) index is a reliable surrogate of insulin resistance and a marker for ischemic stroke (IS) incident. Whether the TyG index predicts stroke outcome remains uncertain. This study investigated the prognostic value of the TyG index in critically ill stroke patients. Methods: This was a retrospective observational study that included stroke patients, and all data were extracted from the eICU Collaborative Research Database. The TyG index was calculated as the ln [fasting glucose level (mg/dL) × triglyceride level (mg/dL)/2]. Outcomes included the hospital and intensive care unit (ICU) death. Multivariate logistic regression was used to determine independent risk factors. The smoothing curves and forest plots were illustrated. Results: A total of 4,570 eligible subjects were enrolled. The mean level of TyG index was 9.1 ± 0.7. The hospital and ICU mortality rate were 10.3 and 5.0%, respectively. TyG index as a continuous variable was associated hospital mortality in univariate analysis (OR 1.723, 95% CI 1.524–1.948, P < 0.001), adjusted model 1 (OR 1.861, 95% CI 1637–2.116, P < 0.001), and adjusted model 2 (OR 2.543, 95% CI 1.588–4.073, P < 0.001). TyG was also associated ICU mortality in univariate analysis (OR 2.146, 95% CI 1.826–2.523, P < 0.001), adjusted model 1 (OR 2.183, 95% CI 1.847–2.580, P < 0.001), and adjusted model 2 (OR 2.672, 95% CI 1.376–5.188, P < 0.001). The smoothing curves observed a continuous linear association after adjusting all covariates both in hospital and ICU mortality. Subgroup analysis demonstrated TyG index was associated with increased risk of hospital and ICU death in critically ill IS (P < 0.05), but not in hemorrhage stroke (P > 0.05). Conclusion: The TyG index is a potential predictor for hospital and ICU mortality in critically ill stroke patients, especially in IS patients.
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spelling pubmed-76559112020-11-13 Triglyceride-Glucose Index Linked to Hospital Mortality in Critically Ill Stroke: An Observational Multicentre Study on eICU Database Zhang, Bingjun Liu, Lingling Ruan, Hengfang Zhu, Qiang Yu, Dafan Yang, Yu Men, Xuejiao Lu, Zhengqi Front Med (Lausanne) Medicine Objective: The triglyceride-glucose (TyG) index is a reliable surrogate of insulin resistance and a marker for ischemic stroke (IS) incident. Whether the TyG index predicts stroke outcome remains uncertain. This study investigated the prognostic value of the TyG index in critically ill stroke patients. Methods: This was a retrospective observational study that included stroke patients, and all data were extracted from the eICU Collaborative Research Database. The TyG index was calculated as the ln [fasting glucose level (mg/dL) × triglyceride level (mg/dL)/2]. Outcomes included the hospital and intensive care unit (ICU) death. Multivariate logistic regression was used to determine independent risk factors. The smoothing curves and forest plots were illustrated. Results: A total of 4,570 eligible subjects were enrolled. The mean level of TyG index was 9.1 ± 0.7. The hospital and ICU mortality rate were 10.3 and 5.0%, respectively. TyG index as a continuous variable was associated hospital mortality in univariate analysis (OR 1.723, 95% CI 1.524–1.948, P < 0.001), adjusted model 1 (OR 1.861, 95% CI 1637–2.116, P < 0.001), and adjusted model 2 (OR 2.543, 95% CI 1.588–4.073, P < 0.001). TyG was also associated ICU mortality in univariate analysis (OR 2.146, 95% CI 1.826–2.523, P < 0.001), adjusted model 1 (OR 2.183, 95% CI 1.847–2.580, P < 0.001), and adjusted model 2 (OR 2.672, 95% CI 1.376–5.188, P < 0.001). The smoothing curves observed a continuous linear association after adjusting all covariates both in hospital and ICU mortality. Subgroup analysis demonstrated TyG index was associated with increased risk of hospital and ICU death in critically ill IS (P < 0.05), but not in hemorrhage stroke (P > 0.05). Conclusion: The TyG index is a potential predictor for hospital and ICU mortality in critically ill stroke patients, especially in IS patients. Frontiers Media S.A. 2020-10-28 /pmc/articles/PMC7655911/ /pubmed/33195355 http://dx.doi.org/10.3389/fmed.2020.591036 Text en Copyright © 2020 Zhang, Liu, Ruan, Zhu, Yu, Yang, Men and Lu. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Zhang, Bingjun
Liu, Lingling
Ruan, Hengfang
Zhu, Qiang
Yu, Dafan
Yang, Yu
Men, Xuejiao
Lu, Zhengqi
Triglyceride-Glucose Index Linked to Hospital Mortality in Critically Ill Stroke: An Observational Multicentre Study on eICU Database
title Triglyceride-Glucose Index Linked to Hospital Mortality in Critically Ill Stroke: An Observational Multicentre Study on eICU Database
title_full Triglyceride-Glucose Index Linked to Hospital Mortality in Critically Ill Stroke: An Observational Multicentre Study on eICU Database
title_fullStr Triglyceride-Glucose Index Linked to Hospital Mortality in Critically Ill Stroke: An Observational Multicentre Study on eICU Database
title_full_unstemmed Triglyceride-Glucose Index Linked to Hospital Mortality in Critically Ill Stroke: An Observational Multicentre Study on eICU Database
title_short Triglyceride-Glucose Index Linked to Hospital Mortality in Critically Ill Stroke: An Observational Multicentre Study on eICU Database
title_sort triglyceride-glucose index linked to hospital mortality in critically ill stroke: an observational multicentre study on eicu database
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7655911/
https://www.ncbi.nlm.nih.gov/pubmed/33195355
http://dx.doi.org/10.3389/fmed.2020.591036
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