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The following is a summary of “Association between the development of sepsis and the triglyceride-glucose index in acute pancreatitis patients: a retrospective investigation utilizing the MIMIC-IV database,” published in the February 2025 issue of the BMC Gastroenterology by Xu et al.

Sepsis is a life-threatening complication of acute pancreatitis (AP) that necessitates prompt detection and intervention to improve patient outcomes. The triglyceride-glucose (TyG) index has been recognized as a predictive biomarker for various metabolic and inflammatory conditions. This study aimed to evaluate the association between the TyG index and sepsis risk in patients with AP, with the goal of enhancing early warning systems and optimizing clinical care. A retrospective analysis was conducted using data from the MIMIC-IV database, including patients who were initially admitted and met the diagnostic criteria for AP (ICD-9: 5770; ICD-10: K85). 

Patients with incomplete demographic or laboratory data were excluded. Sepsis was diagnosed based on the Sepsis-3 criteria, and patients were categorized into sepsis and non-sepsis groups. The TyG index was calculated using the formula ln[(triglycerides mg/dL) × (glucose mg/dL)/2]. Feature selection was performed using the Boruta algorithm and XGBoost model to identify key predictive variables, and logistic regression analyses (both univariate and multivariate) were applied to assess the relationship between the TyG index and sepsis onset. Out of 28,000 patients with AP screened, 661 met the inclusion criteria, with 228 patients (34.5%) developing sepsis. A significant correlation was observed between the TyG index and sepsis risk (OR = 1.891, 95% CI: 1.408–2.555), with an increasing TyG index associated with a higher likelihood of sepsis (all P for trend < 0.001). 

Subgroup analyses further confirmed this positive association across different age groups, sexes, and among patients with hypertension and diabetes (all P for trend < 0.05). The predictive accuracy of the TyG index was significantly enhanced when combined with clinical indicators, achieving an area under the curve (AUC) of 0.828 (95% CI: 0.794–0.862), compared to the TyG index alone (AUC: 0.657, 95% CI: 0.613–0.701), with a statistically significant difference (Z = -7.362, P < 0.001). These findings indicate that the TyG index is strongly associated with an increased risk of sepsis in patients with AP and, when integrated with clinical parameters, demonstrates superior predictive capability. 

The results suggest that the TyG index could serve as a valuable tool for identifying high-risk patients with AP, potentially facilitating earlier interventions and improved sepsis management. Future studies should further validate these findings and explore the implementation of TyG-based risk stratification in clinical practice.

Source: bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-025-03663-y