Triglyceride-glucose index and in-hospital mortality in acute pancreatitis patients admitted to the intensive care unit: a retrospective analysis of the MIMIC-IV database

The triglyceride-glucose (TyG) index, calculated from triglyceride and fasting glucose levels, has garnered increasing attention in predicting cardiovascular and metabolic risks. Our study investigated the relationship between TyG index and in-hospital mortality in acute pancreatitis (AP) admitted to the intensive care unit (ICU), striving to provide a reliable and trustworthy tool for clinical prognosis evaluation. Using data from Medical Information Mart for Intensive Care-IV (MIMIC-IV) database, our study examined relationships between TyG index, in-hospital mortality, systemic inflammatory response syndrome (SIRS), Sequential Organ Failure Assessment (SOFA) score, hospital length of stay (LOS), and intensive care unit (ICU) LOS in ICU-admitted acute pancreatitis (AP). Logistic regression analyses were used to assess the associations between the TyG index and in-hospital mortality. Linear regression analyses were used to assess the relationships between TyG index, SOFA scores, and LOS. Nonlinear relationships between the TyG index and in-hospital mortality, SIRS, and SOFA scores were explored using restricted cubic splines (RCS). A total of 482 ICU-admitted AP cases were analyzed, revealing an in-hospital mortality rate of 14.3%. Logistic regression analysis indicated that an increased TyG index was correlated with a higher risk of in-hospital mortality (Model 1). After adjusting for confounders, the odds ratios (OR) in Models 2 and 3 were 1.44 (P = 0.03) and 1.51 (P = 0.02), respectively. When categorized into tertile, the third tertile showed a significantly higher mortality trend (P = 0.004). Supplementary and sensitivity analyses confirmed these results, even after further categorizing the TyG index or performing multiple imputations. Nonlinear restricted cubic spline (RCS) models demonstrated a strong nonlinear relationship between the TyG index and in-hospital mortality, which remained consistent across various models. Our findings also showed that the TyG index was strongly associated with SIRS and ICU LOS, but not with SOFA score or hospitalization duration. This study identifies the TyG index as independently associated with in-hospital mortality, SIRS, and ICU LOS in ICU-admitted AP individuals and provides valuable information for clinical decision-making.