预测心脏手术后死亡率的甘油三酯指数

IF 4.6 2区综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES iScience Pub Date : 2024-11-15 DOI:10.1016/j.isci.2024.111107

Huili Li , Fei Xiao , Haiqiang Ren , Fei Xu , Hao Che , Huadong Zhu , Chenghui Zhou , Sheng Wang

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引用次数: 0

摘要

背景甘油三酯-葡萄糖（TyG）指数是胰岛素抵抗的标志物，与不良心脏预后有关。本研究分析了重症监护医学信息市场第四版（MIMIC-IV）数据库中的 1,810 名心脏手术患者，并按 TyG 指数水平进行了分类。死亡率是主要结果，通过 Cox 比例危险度回归、时间依赖性接收器操作特征（ROC）分析和限制性三次样条进行评估。TyG指数水平越高，死亡风险越高（危险比 [HR] = 1.206，95% 置信区间 [CI]，1.121-1.297，p <0.001）。随时间变化的ROC分析显示，1年、3年和5年的曲线下面积（AUC）分别为0.914、0.857和0.801。结论TyG指数水平升高与心脏手术后较高的死亡率风险显著相关，这突显了其作为该人群预后标志物的潜力。

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Triglyceride index as a predictor of mortality after cardiac surgery

Background

The triglyceride-glucose (TyG) index, a marker for insulin resistance, has been linked to adverse cardiac outcomes. Its role in predicting mortality following cardiac surgery remains unclear.

Methods

This study analyzed 1,810 cardiac surgery patients from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, categorized by TyG index levels. Mortality was the primary outcome, assessed through Cox proportional hazards regression, time-dependent receiver operating characteristic (ROC) analysis, and restricted cubic splines.

Results

Over a 13-year follow-up, 83 patients died. Higher TyG index levels were associated with increased mortality risk (hazard ratio [HR] = 1.206, 95% confidence interval [CI], 1.121–1.297, p < 0.001). Time-dependent ROC analysis showed areas under the curve (AUCs) of 0.914, 0.857, and 0.801 at 1, 3, and 5 years, respectively. The TyG index-based model outperformed established scoring systems in predicting mortality.

Conclusions

Elevated TyG index levels are significantly associated with higher mortality risk after cardiac surgery, highlighting its potential as a prognostic marker in this population.

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来源期刊

iScience Multidisciplinary-Multidisciplinary

CiteScore

7.20

自引率

1.70%

发文量

1972

审稿时长

6 weeks

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