Lipids & metabolic liver disease
Comparative prognostic value of triglyceride-glucose (TyG) index and triglyceride-glucose-body mass index (TyG-BMI) for 90-day all-cause mortality in critically ill older adults with ASCVD: a machine learning analysis of the MIMIC-IV database
Authors' conclusion
In elderly critically ill patients with ASCVD, the TyG index showed better prognostic performance than TyG-BMI and was an independent predictor of 90-day mortality. These findings suggest that the TyG index may be a useful and cost-effective biomarker for risk stratification in this high-risk population.
Study context
- Population
- Critically ill patients aged ≥ 65 years with ASCVD, MIMIC-IV database
- Participants
- 2,368 patients
- Exposure
- TyG index vs TyG-BMI for prognosis
- Outcome
- All-cause mortality
- Follow-up
- 90 days
Methodological detailsMIMIC-IV database, machine learning analysis
- MIMIC-IV database
- Machine learning analysis
Main finding
As reported in the abstract
90-day all-cause mortality (multivariable Cox)
TyG index independently associated with higher 90-day mortality risk, HR
1.114
95% CI 1.014–1.225P = 0.025
Observational data: associations, not effects.
Further findings
Mortality during follow-up
- Died during follow-up
- 18.5%
Survival by TyG index quartiles (Kaplan-Meier)
- Progressively worse survival across increasing TyG index quartiles
Machine learning discrimination
- XGBoost best discrimination: Area under the precision-recall curve (AUPRC)
- 0.455
- XGBoost specificity
- 0.912
- Adding TyG-BMI did not significantly improve AUC (P = 0.101)
- 0.783
- TyG index consistently outperformed TyG-BMI in ML models
- Adding TyG index improved AUC from 0.763 to 0.794 (P = 0.005)
- SHAP: TyG index most important metabolic predictor
Original publication
Comparative prognostic value of TyG index and TyG-BMI for 90-day all-cause mortality in critically ill older adults with ASCVD: a machine learning analysis of the MIMIC-IV database. Cardiovasc Diabetol. Published 17 May 2026. doi:10.
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