Abstract
OBJECTIVE: To investigate the prognostic value of the triglyceride-glucose index(TyG) in patients with hypertensive cerebral hemorrhage. METHODS: This study selected critically ill patients with intracerebral hemorrhage (ICH) who required intensive care unit (ICU) admission from the Medical Information Mart for Intensive Care (MIMIC-IV) database and divided them into quartiles according to the level of the TyG index. The outcomes included in-hospital mortality and ICU mortality. Cox proportional hazards regression analysis and restricted cubic spline analysis were used to explore the relationship between the TyG index and clinical outcomes in critically ill patients with ICH. RESULTS: A total of 686 patients (55.8% male) were included. The in-hospital mortality rate was 10.8%, and the ICU mortality rate was 6.1%. Baseline data indicated that patients with higher TyG index values tended to present with more severe organ dysfunction. Cox proportional hazards regression analysis showed that, when the TyG index was modeled as a categorical variable, higher quartiles were significantly associated with an increased risk of in-hospital death: unadjusted model [HR 2.57, 95% CI 1.13-5.84; p = 0.025] and partially adjusted model [HR 2.43, 95% CI 1.03-5.75; p = 0.043]. When analyzed as a continuous variable, the TyG index was not an independent risk factor. Kaplan-Meier survival analysis demonstrated no significant difference in ICU mortality across quartiles (log-rank p = 0.093), while the difference in in-hospital mortality did not reach statistical significance (log-rank p = 0.059). Restricted cubic spline (RCS) regression models showed no evidence of non-linearity for ICU mortality (P-nonlinear = 0.078), whereas a significant non-linear association was observed for in-hospital mortality (P-nonlinear = 0.046). Subgroup analyses suggested that patients aged ≥ 65 years [HR 1.54, 95% CI 0.97-2.45] and those with APS III scores > 36 [HR 1.50, 95% CI 0.98-2.02] showed a trend toward increased in-hospital mortality, although these results did not reach statistical significance. CONCLUSIONS: The TyG index can reflect the severity of organ damage in patients with ICH and can predict the in-hospital mortality of critically ill patients.