Hemorrhagic stroke (HS), encompassing non-traumatic intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH), constitutes a significant portion of cerebrovascular events, comprising approximately 30% of stroke incidents.
The triglyceride-glucose index (TyG-i) serves as a precise indicator of insulin resistan0% of stroke incidents. ce and presents a pivotal metabolic disturbance. While existing literature has established an association between TyG-i and all-cause mortality in patients with ischemic stroke (IS), its prognostic implications remain unclear for critically ill patients with HS who require ICU admission.
Given the substantially elevated mortality and morbidity associated with HS compared to IS, investigating this association is imperative, according to authors of a recent study published in Cardiology.
Co-lead authors Yongwei Huang, Zongping Li, and colleagues used the International Classification of Diseases (ICD)-9/10 diagnostic guidelines to identify 1,475 critically ill patients with HS using the Medical Information Mart for Intensive Care-IV (MIMIC-IV, version 2.2) database. They stratified patients into quartiles based on TyG-i scores and assessed mortality outcomes at ICU admission, in-hospital, 30 days, 90 days, and 1 year. The investigators used Cox proportional hazards regression analysis and restricted cubic splines (RCS) to elucidate the relationship between TyG-i and all-cause mortality. They estimated survival curves with the Kaplan-Meier method.
Mortality rates observed in the ICU, hospital, at 30 days, 90 days, and 1 year were 7.3%, 10.9%, 13.8%, 19.7%, and 27.3%, respectively. Researchers found a significant association between elevated TyG-i levels and all-cause mortality at 30 days (aHR, 1.32; 95% CI: 1.05-1.67; P=0.020), 90 days (aHR, 1.27; 95% CI: 1.04-1.55; P=0.019), and 1 year (aHR, 1.22; 95% CI: 1.03-1.44; P=0.023). RCS analysis revealed that rising TyG-I levels were associated with a progressive increase in all-cause mortality risk, with no significant effect modification observed in interaction tests.
“Applying TyG-i in clinical settings could enhance therapeutic decision-making and the management of disease trajectories,” the researchers concluded. “Additionally, this investigation augments existing research on the linkage between the TyG-i and IS, elucidating the TyG-i’s role in predicting mortality across diverse stroke categories.”
