Association between the triglyceride–glucose index and mortality in critically ill patients: A meta-analysis

Abstract

Background: To further identify the association of the triglyceride–glucose (TyG) index with the risk of mortality among critically ill patients admitted to the intensive care unit (ICU). Methods: The PubMed, Web of Science, and EMBASE databases were searched for relevant studies up to February 2, 2024. The primary outcomes were in-hospital mortality and ICU mortality. The secondary outcomes were 30-day mortality, 90-day mortality, and 1-year mortality. The hazard ratios (HRs) with 95% confidence intervals (CIs) were combined to evaluate the associations between the TyG index and the above endpoints. All the statistical analyses were performed with STATA 15.0 software. Results: Ten studies involving 22,694 patients were included. The pooled results demonstrated that an elevated TyG index indicated an increased risk of in-hospital mortality (HR = 1.76, 95% CI: 1.41–2.18, P < .001), ICU mortality (HR = 1.52, 95% CI: 1.33–1.74, P < .001), 30-day mortality (HR = 1.50, 95% CI: 1.02–2.19, P = .037), 90-day mortality (HR = 1.42, 95% CI: 1.01–2.00, P = .043), and 1-year mortality (HR = 1.19, 95% CI: 1.11–1.28, P < .001). Subgroup analysis for in-hospital mortality and ICU mortality based on sex, age, body mass index and hypertension showed similar results. However, subgroup analysis stratified by diabetes mellitus (DM) revealed that the associations of the TyG index with in-hospital mortality (HR = 2.21, 95% CI: 1.30–3.78, P = .004) and ICU mortality (HR = 1.93, 95% CI: 0.95–3.94, P = .070) were observed only among patients without DM. Conclusion: The TyG index was significantly associated with mortality among critically ill patients without DM, and an elevated TyG index predicted an increased risk of mortality.