Triglyceride-glucose index: a novel assessment tool for all-cause mortality in critical stroke patients—a retrospective analysis of the eICU-CRD database
Abstract Background Stroke, a leading cause of death and disability, includes ischemic (IS), hemorrhagic (HS), and subarachnoid subtypes. While the triglyceride-glucose index (TyG) has been linked to cerebrovascular diseases, studies focus on single subtypes and lack ICU data. The prognostic roles o...
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BMC
2025-07-01
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| Series: | Cardiovascular Diabetology |
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| Online Access: | https://doi.org/10.1186/s12933-025-02872-9 |
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| author | Bo Wu Wanli Yu Gang Zhang Haotian Jiang Nan Wu |
| author_facet | Bo Wu Wanli Yu Gang Zhang Haotian Jiang Nan Wu |
| author_sort | Bo Wu |
| collection | DOAJ |
| description | Abstract Background Stroke, a leading cause of death and disability, includes ischemic (IS), hemorrhagic (HS), and subarachnoid subtypes. While the triglyceride-glucose index (TyG) has been linked to cerebrovascular diseases, studies focus on single subtypes and lack ICU data. The prognostic roles of the atherogenic index of plasma (AIP) and total cholesterol-to-HDL ratio (TC_HDL) in critically ill stroke patients’ all-cause mortality (ACM) remain unexplored. This study investigates these indices’ associations with ACM in critically ill stroke patients. Methods We screened 3247 ICU-admitted stroke patients from the eICU-CRD, stratified by TyG, AIP, and TC_HDL quartiles. Endpoints were in-hospital and ICU mortality. Analyses used Cox regression, Kaplan–Meier curves, and restricted cubic splines. Results In-hospital and ICU mortality rates were 17.2% and 9.7%, respectively. Multivariate Cox analysis showed elevated TyG correlated with higher ICU mortality [HR 1.528, 95% CI 1.252–1.771, *P* = 0.002] and in-hospital mortality [HR 1.434, 95% CI 1.04–1.619, *P* = 0.013]. Elevated AIP associated with higher ICU [HR 1.342, *P* = 0.021] and in-hospital mortality [HR 1.631, *P* = 0.005]. TC_HDL showed no significant associations. Kaplan–Meier curves confirmed TyG’s links to both mortalities and AIP’s association with in-hospital mortality. Restricted cubic splines revealed increasing risk with higher TyG. Conclusion TyG shows stronger correlations with short-term ICU and in-hospital mortality in critically ill stroke patients compared to AIP and TC_HDL. Monitoring TyG may aid prognostic assessment and risk stratification, supporting optimized treatment strategies and aligning with prior research on TyG and stroke outcomes. Graphical abstract |
| format | Article |
| id | doaj-art-ec2cec60c6e14e4db86901ebc4b6aed2 |
| institution | DOAJ |
| issn | 1475-2840 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj-art-ec2cec60c6e14e4db86901ebc4b6aed22025-08-20T03:04:14ZengBMCCardiovascular Diabetology1475-28402025-07-0124112110.1186/s12933-025-02872-9Triglyceride-glucose index: a novel assessment tool for all-cause mortality in critical stroke patients—a retrospective analysis of the eICU-CRD databaseBo Wu0Wanli Yu1Gang Zhang2Haotian Jiang3Nan Wu4Department of Neurosurgery, Chongqing General Hospital, School of Medicine, Chongqing UniversityDepartment of Neurosurgery, Chongqing General Hospital, School of Medicine, Chongqing UniversityDepartment of Neurosurgery, Chongqing General Hospital, School of Medicine, Chongqing UniversityDepartment of Neurosurgery, Chongqing General Hospital, School of Medicine, Chongqing UniversityDepartment of Neurosurgery, Chongqing General Hospital, School of Medicine, Chongqing UniversityAbstract Background Stroke, a leading cause of death and disability, includes ischemic (IS), hemorrhagic (HS), and subarachnoid subtypes. While the triglyceride-glucose index (TyG) has been linked to cerebrovascular diseases, studies focus on single subtypes and lack ICU data. The prognostic roles of the atherogenic index of plasma (AIP) and total cholesterol-to-HDL ratio (TC_HDL) in critically ill stroke patients’ all-cause mortality (ACM) remain unexplored. This study investigates these indices’ associations with ACM in critically ill stroke patients. Methods We screened 3247 ICU-admitted stroke patients from the eICU-CRD, stratified by TyG, AIP, and TC_HDL quartiles. Endpoints were in-hospital and ICU mortality. Analyses used Cox regression, Kaplan–Meier curves, and restricted cubic splines. Results In-hospital and ICU mortality rates were 17.2% and 9.7%, respectively. Multivariate Cox analysis showed elevated TyG correlated with higher ICU mortality [HR 1.528, 95% CI 1.252–1.771, *P* = 0.002] and in-hospital mortality [HR 1.434, 95% CI 1.04–1.619, *P* = 0.013]. Elevated AIP associated with higher ICU [HR 1.342, *P* = 0.021] and in-hospital mortality [HR 1.631, *P* = 0.005]. TC_HDL showed no significant associations. Kaplan–Meier curves confirmed TyG’s links to both mortalities and AIP’s association with in-hospital mortality. Restricted cubic splines revealed increasing risk with higher TyG. Conclusion TyG shows stronger correlations with short-term ICU and in-hospital mortality in critically ill stroke patients compared to AIP and TC_HDL. Monitoring TyG may aid prognostic assessment and risk stratification, supporting optimized treatment strategies and aligning with prior research on TyG and stroke outcomes. Graphical abstracthttps://doi.org/10.1186/s12933-025-02872-9Triglyceride-glucose indexTotal cholesterol-to-high-density lipoprotein cholesterol ratioAtherogenic index of plasmaStrokeeICU-CRD databaseAll-cause mortality |
| spellingShingle | Bo Wu Wanli Yu Gang Zhang Haotian Jiang Nan Wu Triglyceride-glucose index: a novel assessment tool for all-cause mortality in critical stroke patients—a retrospective analysis of the eICU-CRD database Cardiovascular Diabetology Triglyceride-glucose index Total cholesterol-to-high-density lipoprotein cholesterol ratio Atherogenic index of plasma Stroke eICU-CRD database All-cause mortality |
| title | Triglyceride-glucose index: a novel assessment tool for all-cause mortality in critical stroke patients—a retrospective analysis of the eICU-CRD database |
| title_full | Triglyceride-glucose index: a novel assessment tool for all-cause mortality in critical stroke patients—a retrospective analysis of the eICU-CRD database |
| title_fullStr | Triglyceride-glucose index: a novel assessment tool for all-cause mortality in critical stroke patients—a retrospective analysis of the eICU-CRD database |
| title_full_unstemmed | Triglyceride-glucose index: a novel assessment tool for all-cause mortality in critical stroke patients—a retrospective analysis of the eICU-CRD database |
| title_short | Triglyceride-glucose index: a novel assessment tool for all-cause mortality in critical stroke patients—a retrospective analysis of the eICU-CRD database |
| title_sort | triglyceride glucose index a novel assessment tool for all cause mortality in critical stroke patients a retrospective analysis of the eicu crd database |
| topic | Triglyceride-glucose index Total cholesterol-to-high-density lipoprotein cholesterol ratio Atherogenic index of plasma Stroke eICU-CRD database All-cause mortality |
| url | https://doi.org/10.1186/s12933-025-02872-9 |
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