Triglyceride-glucose index and short-term mortality of adult patients with sepsis: a meta-analysis

Background The triglyceride–glucose (TyG) index, a surrogate marker of insulin resistance, has been associated with outcomes in sepsis, but existing evidence is inconsistent. This meta-analysis aimed to evaluate the association between a high TyG index and short-term mortality in adult patients with sepsis. Methods A systematic search of PubMed, Embase, Web of Science, Wanfang, and CNKI was conducted to identify observational studies reporting the association between TyG index and short-term mortality (in-hospital or ≤30-day) in adult sepsis patients. Effect estimates were pooled using a random-effects model accounting for the influence of heterogeneity. Results Eight retrospective cohort studies involving 14,772 patients were included. Overall, a higher TyG index was associated with increased short-term mortality (odds ratio [OR] 1.72, 95% confidence intervals 1.44–2.04; I² = 53%). Subgroup analyses showed consistent associations across mean age, proportion of men, and diabetic status (non-diabetic vs. mixed populations: p for subgroup difference all > 0.05). The association remained significant regardless of cutoff determination methods, cutoff values, outcome type (in-hospital vs. 28-day mortality), and study quality scores ( p for subgroup difference all > 0.05). Meta-regression analyses did not suggest the association was significantly modified by mean age, proportion of men, proportion of diabetic patients, cutoff values of TyG index, or study quality scores ( p all > 0.05). Conclusions A higher TyG index is associated with an increased risk of short-term mortality in adult patients with sepsis, supporting its potential role as a simple prognostic marker in clinical practice. Systematic Review Registration https://www.crd.york.ac.uk/prospero/ , identifier CRD420261389660.