Association between the triglyceride glucose index and short-term mortality in septic patients with or without obesity: a retrospective cohort study

Sepsis is a significant contributor to both intensive care unit (ICU) admissions and mortality among patients in ICU, with a rising prevalence of obesity. There is a lack of extensive research on the correlation between TyGI and findings in patients with sepsis, especially in obese patients. This study used a retrospective cohort design and included patients with sepsis (≥18 years) from the Medical Information Mart for Intensive Care IV database. The association between TyGI and outcome was examined using multivariable logistic regression analysis. 8,840 patients with sepsis were included in the analysis. The in-ICU mortality rate was 9.7%. Non-survivors exhibited significantly greater TyGI levels than survivors [9.19(8.76–9.71) vs. 9.10(8.67–9.54), <i>p</i> &lt; 0.001]. The adjusted multivariate regression model showed that elevated TyGI values were linked to a greater likelihood of death in ICU (odds ratio [OR] range 1.072–1.793, <i>p</i> &lt; 0.001) and hospital (OR range 1.068–1.445, <i>p</i> = 0.005). Restricted Cubic Spline analysis revealed a nonlinear association between TyGI and in-ICU and in-hospital mortality risks within specified ranges. Subgroup analysis revealed interaction effects in the general obesity, abdominal obesity, and impaired fasting glucose subgroups (<i>p</i> = 0.014, 0.016, and &lt; 0.001, respectively). TyGI was associated with an increased sepsis-related short-term mortality risk and adverse outcomes after ICU admission.脓毒症（Sepsis）是重症监护病房（ICU）患者收治及ICU内死亡的重要危险因素，且当前肥胖患病率呈上升趋势。目前针对脓毒症患者（尤其肥胖患者）的TyGI与临床结局相关性的深入研究仍较为匮乏。本研究采用回顾性队列研究设计，纳入来自重症医学信息库IV（Medical Information Mart for Intensive Care IV, MIMIC-IV）中年龄≥18岁的脓毒症患者。采用多变量logistic回归分析检验TyGI与患者结局的关联。本研究共纳入8840例脓毒症患者，其ICU内死亡率为9.7%。非存活患者的TyGI水平显著高于存活患者[9.19(8.76–9.71) vs. 9.10(8.67–9.54)，p<0.001]。校正后的多变量回归模型显示，TyGI水平升高与ICU内死亡风险升高相关（优势比[odds ratio, OR]范围为1.072~1.793，p<0.001），同时也与住院死亡风险升高相关（OR范围为1.068~1.445，p=0.005）。限制性立方样条（Restricted Cubic Spline）分析显示，在特定范围内，TyGI与ICU内及住院期间的死亡风险呈非线性关联。亚组分析显示，在总体肥胖、腹型肥胖及空腹血糖受损亚组中存在交互效应（分别对应p=0.014、0.016及p<0.001）。综上，TyGI与脓毒症相关短期死亡风险升高及ICU收治后的不良临床结局显著相关。