Dynamic association between triglyceride-glucose-body mass index and hospital mortality in critically ill patients with heart failure: a multicenter retrospective cohort study
Authors' conclusion
TYG-BMI demonstrates a reproducible, U-shaped association with hospital mortality in critically ill HF patients. Both intensity and exposure duration contribute to risk stratification, though prospective validation is warranted given the observational design and uncertain physiological specificity of TYG-BMI in the ICU setting.
Study context
- Population
- Adult critically ill heart failure (HF) patients with daily triglyceride-glucose-body mass index (TYG-BMI) measurements during the 7 day observation period (day 0 through day 7)
- Participants
- 5,133 patients
- Exposure
- TYG-BMI intensity and exposure duration and hospital mortality
- Outcome
- Hospital mortality
Methodological detailsMIMIC-III, MIMIC-IV and eICU databases
- MIMIC-III, MIMIC-IV and eICU databases
Main finding
As reported in the abstract
Hospital mortality by TYG-BMI
- Pooled mortality
- 27.9%
- Non-linear U-shaped dose-response relationship in MIMIC-IV (restricted cubic spline), non-linear P
- P < 0.001
- Optimal TYG-BMI range 250-275, OR
- 0.76 (95% CI 0.68-0.85, P < 0.001 in MIMIC-IV)
- Each additional day within 250-275 reduced mortality risk (P < 0.01)
- 0.4%
- TYG-BMI 425-450 range, OR (95% CI 1.35-1.93); TYG-BMI > 425 associated with progressively increased mortality
- 1.61
- Time-dependent risk amplification per day at the highest stratum
- 2.5%
Observational data: associations, not effects.
Further findings
| Outcome | TYG-BMI + SOFA | SOFA alone | P value |
|---|---|---|---|
| Discrimination: TYG-BMI + SOFA vs SOFA alone | DeLong P < 0.001 | ||
| AUC | 0.780 | 0.720 |
Sensitivity analyses
- All sensitivity analyses yielded consistent findings
Original publication
Dynamic association between triglyceride-glucose-body mass index and hospital mortality in critically ill patients with heart failure: a multicenter retrospective cohort study. Cardiovasc Diabetol. Published 24 March 2026. doi:10.
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