Combined assessment of triglyceride-glucose index and stress hyperglycemia ratio to predict all-cause mortality in critically ill patients with intracerebral hemorrhage

The triglyceride-glucose (TyG) index and stress hyperglycemia ratio (SHR) are emerging biomarkers in cerebrovascular disease, but their combined prognostic value for mortality among critically ill patients with intracerebral hemorrhage (ICH) has not been well elucidated. Therefore, this study aimed to assess the prognostic value of the combined TyG index and SHR for all-cause mortality in patients with ICH.

This retrospective study included patients from the Medical Information Mart for Intensive Care (MIMIC)-IV database. Based on the quartiles of the TyG index and the median of the SHR, the study cohort was categorized into eight groups. The primary outcome was 28-day all-cause mortality, with in-hospital all-cause mortality as the secondary outcome. The association of the combined TyG index and SHR with all-cause mortality was assessed through Kaplan-Meier curves, Cox proportional hazards regression models, restricted cubic splines (RCS) curves, and subgroup analyses.

The study included a total of 1,095 patients with a median age of 72.73 years (IQR 61.65–82.46), of whom 53.70% were male. The 28-day mortality and in-hospital mortality rates were 20.37% and 15.16%, respectively. Compared to the reference group (TyG ≤ 9.15 and SHR ≤ 1.02), patients with TyG > 9.15 and SHR > 1.02 demonstrated the highest risk for both 28-day mortality (HR 2.483, 95% CI 1.497–4.121) and in-hospital mortality (HR 3.182, 95% CI 1.604–6.310). The ROC also confirmed the combined TyG index and SHR had more robust predictive power for 28-day mortality and in-hospital mortality than the TyG index and SHR itself. Subgroup analyses further revealed consistent associations of the combined TyG index and SHR with both 28-day mortality and in-hospital mortality.

Combined TyG index and SHR assessment served as a critical prognostic tool for critically ill patients with ICH.