甘油三酯-葡萄糖指数对重症监护室急性心力衰竭患者院内死亡率的预测价值OA

Objective:To investigate the association between the triglyceride-glucose(TyG)index and in-hospital mortality among patients with acute heart failure(AHF)admitted to the Intensive Care Unit(ICU),and to evaluate its prognostic value.Method:This retrospective cohort study included 2014 eligible patients with AHF identified from the MIMIC-Ⅳ database from 2008 to 2019.Patients were divided into a low-TyG group(TyG<9.28)and a high-TyG group(TyG≥9.28)according to the median TyG value,with 1 007 patients in each group.Clinical characteristics were compared between the two groups.Univariate and multivariate logistic regression analyses were performed to examine the association between TyG and in-hospital mortality.Receiver operating characteristic(ROC)curve analysis was used to assess the predictive performance of TyG.Result:Compared with the low-TyG group,patients in the high-TyG group were younger and had higher heart rate,white blood cell count,serum creatinine,blood glucose,triglyceride levels,prevalence of diabetes,longer hospital stay,and higher in-hospital mortality(P<0.05).Multivariate logistic regression analysis showed that,after adjustment for age,sex,heart rate,mean arterial pressure,white blood cell count,platelet count,hemoglobin,serum creatinine,diabetes,hypertension,cerebrovascular disease,liver dysfunction,and chronic kidney disease,elevated TyG remained independently associated with an increased risk of in-hospital mortality.When analyzed as a continuous variable,the odds ratio(OR)was 1.26(95％CI:1.08～1.48,P=0.004).When analyzed as a categorical variable,the high-TyG group had a significantly higher risk of in-hospital mortality than the low-TyG group(OR=1.41,95％CI:1.08～1.83,P=0.011).ROC analysis showed that the area under the curve(AUC)of TyG for predicting in-hospital mortality in ICU patients with AHF was 0.701(95％CI:0.665～0.737).Conclusion:Elevated TyG was independently associated with an increased risk of in-hospital mortality in ICU patients with AHF and showed modest prognostic value.TyG may serve as a simple and readily available marker for early risk stratification in this population.