Introduction
Methods
Study population
Data collection
Primary outcome and clinical definition
Statistical analysis
Results
Categories | Overall | Q1 | Q2 | Q3 | Q4 | P-value |
---|---|---|---|---|---|---|
(N = 1618) | (N = 389) | (N = 412) | (N = 410) | (N = 407) | ||
Age, years | 68.05 (14.05) | 70.38 (14.50) | 69.46 (14.08) | 67.80 (13.72) | 64.66 (13.28) | < 0.001 |
Male, n (%) | 1054 (65.14) | 262 (67.35) | 264 (64.08) | 266 (64.88) | 262 (64.37) | 0.762 |
BMI, kg/m2 | 29.60 (14.85) | 29.03 (23.79) | 28.99 (11.18) | 28.86 (6.38) | 31.40 (13.44) | 0.180 |
SOFA score | 3.00 (2.58) | 2.62 (2.22) | 2.71 (2.22) | 3.21 (2.65) | 3.43 (3.04) | < 0.001 |
SIRS score | 2.43 (1.05) | 2.27 (1.02) | 2.35 (1.05) | 2.53 (1.04) | 2.55 (1.07) | < 0.001 |
APSIII | 37.29 (17.14) | 36.02 (15.26) | 35.68 (15.60) | 37.70 (17.51) | 39.72 (19.55) | 0.003 |
SAPSII | 32.45 (12.62) | 31.50 (11.55) | 31.98 (11.50) | 33.15 (13.03) | 33.12 (14.15) | 0.159 |
Comorbidities, n (%) | ||||||
Heart failure | 651 (40.23) | 143 (36.76) | 158 (38.35) | 165 (40.24) | 185 (45.45) | 0.067 |
Hypertension | 866 (53.52) | 195 (50.13) | 228 (55.34) | 220 (53.66) | 223 (54.79) | 0.455 |
Atrial fibrillation | 401 (24.78) | 114 (29.31) | 100 (24.27) | 101 (24.63) | 86 (21.13) | 0.064 |
Dyslipidemia | 420 (25.96) | 94 (24.16) | 106 (25.73) | 97 (23.66) | 123 (30.22) | 0.131 |
Diabetes | 484 (29.91) | 47 (12.08) | 77 (18.69) | 140 (34.15) | 220 (54.05) | < 0.001 |
Respiratory failure | 183 (11.31) | 27 (6.94) | 33 (8.01) | 57 (13.90) | 66 (16.22) | < 0.001 |
AKIb | 830 (51.30) | 181 (46.53) | 182 (44.17) | 228 (55.61) | 239 (58.72) | < 0.001 |
CKD | 179 (11.06) | 43 (11.05) | 38 (9.22) | 45 (10.98) | 53 (13.02) | 0.390 |
AMI | 1,126 (69.65) | 264 (67.87) | 289 (70.15) | 282 (68.78) | 291 (71.50) | 0.698 |
PCI | 1,127 (69.65) | 261 (67.10) | 286 (69.42) | 292 (71.22) | 288 (70.76) | 0.588 |
CABG | 186 (11.50) | 41 (10.54) | 35 (8.50) | 64 (15.61) | 46 (11.30) | 0.013 |
Laboratory tests | ||||||
WBC, K/uL | 11.76 (5.04) | 10.91 (4.61) | 11.33 (5.03) | 11.88 (4.64) | 12.87 (5.59) | < 0.001 |
Lymphocyte, % | 15.24 (9.92) | 15.69 (11.10) | 15.37 (10.40) | 14.72 (8.72) | 15.25 (9.48) | 0.699 |
Neutrophil, % | 77.80 (12.16) | 77.67 (13.16) | 77.04 (12.71) | 78.36 (10.68) | 78.04 (12.16) | 0.612 |
RBC, m/uL | 4.17 (0.68) | 4.10 (0.68) | 4.18 (0.62) | 4.18 (0.68) | 4.23 (0.74) | 0.040 |
Platelet, K/uL | 250.27 (96.86) | 245.36 (104.94) | 249.52 (88.84) | 252.96 (98.43) | 253.00 (95.15) | 0.645 |
Hemoglobin, g/dL | 12.67 (2.07) | 12.46 (2.01) | 12.73 (1.95) | 12.69 (2.13) | 12.77 (2.15) | 0.150 |
Serum potassium, mEq/L | 4.22 (0.77) | 4.15 (0.68) | 4.22 (0.75) | 4.18 (0.76) | 4.34 (0.87) | 0.004 |
Serum sodium, mEq/L | 138.23 (4.00) | 138.09 (4.52) | 138.67 (3.53) | 138.11 (3.81) | 138.03 (4.07) | 0.078 |
TC, mg/dL | 161.20 (46.30) | 148.67 (42.10) | 161.24 (48.04) | 165.06 (45.82) | 169.44 (46.53) | < 0.001 |
TG, mg/dL | 132.82 (89.64) | 64.82 (22.25) | 101.80 (28.19) | 134.34 (45.68) | 227.71 (119.13) | < 0.001 |
LDL, mg/dL | 90.99 (39.95) | 85.43 (35.95) | 94.35 (42.71) | 95.15 (39.97) | 88.63 (40.04) | 0.001 |
HDL, mg/dL | 45.05 (14.21) | 50.65 (15.15) | 46.46 (13.66) | 43.60 (13.38) | 39.54 (12.27) | < 0.001 |
HbA1c, % | 6.45 (1.42) | 5.95 (0.98) | 6.04 (0.79) | 6.25 (1.19) | 7.47 (1.85) | < 0.001 |
Glucose, mg/dL | 165.39 (86.07) | 134.58 (51.49) | 146.48 (52.93) | 166.13 (83.95) | 213.46 (116.12) | < 0.001 |
Albumin, g/dL | 3.49 (0.58) | 3.48 (0.54) | 3.48 (0.60) | 3.50 (0.54) | 3.49 (0.63) | 0.967 |
Ucr, mg/dL | 95.46 (65.61) | 98.04 (66.63) | 99.33 (60.41) | 89.65 (62.52) | 95.71 (72.06) | 0.785 |
Scr, mg/dL | 1.27 (1.11) | 1.22 (1.21) | 1.24 (1.02) | 1.25 (1.00) | 1.36 (1.19) | 0.270 |
BUN, mg/dL | 24.30 (15.87) | 22.54 (12.96) | 23.46 (14.17) | 24.67 (16.45) | 26.44 (18.92) | 0.004 |
TyG index | 9.14 (0.71) | 8.27 (0.37) | 8.88 (0.13) | 9.33 (0.14) | 10.06 (0.43) | < 0.001 |
Events | ||||||
LOS ICU, days | 3.89 (5.80) | 3.40 (6.03) | 3.56 (5.28) | 3.92 (4.62) | 4.65 (6.96) | 0.011 |
LOS Hospital, days | 7.11 (7.70) | 6.42 (7.10) | 6.63 (7.08) | 7.11 (6.22) | 8.27 (9.81) | 0.003 |
ICU mortality, n (%) | 123 (7.60) | 16 (4.11) | 28 (6.80) | 40 (9.76) | 39 (9.58) | 0.007 |
Hospital mortality, n (%) | 156 (9.64) | 20 (5.14) | 35 (8.50) | 50 (12.20) | 51 (12.53) | 0.001 |
Baseline characteristics
Characteristic | Overall | Survivors | Non-survivors | P-value |
---|---|---|---|---|
(N = 1618) | (N = 1462) | (N = 156) | ||
Age, years | 68.05 (14.05) | 67.31 (14.08) | 74.97 (11.74) | < 0.001 |
Male, n (%) | 1054 (65.14) | 963 (65.87) | 91 (58.33) | 0.060 |
BMI, kg/m2 | 29.60 (14.85) | 29.79 (15.50) | 27.93 (6.37) | 0.256 |
SOFA score | 3.00 (2.58) | 2.70 (2.26) | 5.80 (3.50) | < 0.001 |
SIRS score | 2.43 (1.05) | 2.35 (1.04) | 3.11 (0.92) | < 0.001 |
APSIII | 37.29 (17.14) | 35.03 (14.58) | 58.44 (23.72) | < 0.001 |
SAPSII | 32.45 (12.62) | 30.72 (11.04) | 48.68 (14.81) | < 0.001 |
Comorbidities, n (%) | ||||
Heart failure | 651 (40.23) | 574 (39.26) | 77 (49.36) | 0.014 |
Hypertension | 866 (53.52) | 793 (54.24) | 73 (46.79) | 0.076 |
Atrial fibrillation | 401 (24.78) | 330 (22.57) | 71 (45.51) | < 0.001 |
Dyslipidemia | 420 (25.96) | 386 (26.40) | 34 (21.79) | 0.212 |
Diabetes | 484 (29.91) | 436 (29.82) | 48 (30.77) | 0.806 |
Respiratory failure | 183 (11.31) | 119 (8.14) | 64 (41.03) | < 0.001 |
AKIa | 830 (51.30) | 707 (48.36) | 123 (78.85) | < 0.001 |
CKD | 179 (11.06) | 152 (10.40) | 27 (17.31) | 0.009 |
AMI | 1126 (69.59) | 1022 (69.90) | 104 (66.67) | 0.403 |
PCI | 1127 (69.65) | 1058 (72.37) | 69 (44.23) | < 0.001 |
CABG | 186 (11.50) | 177 (12.11) | 9 (5.77) | 0.018 |
Laboratory tests | ||||
WBC, K/uL | 11.76 (5.04) | 11.57 (4.91) | 13.52 (5.80) | < 0.001 |
Lymphocyte, % | 15.24 (9.92) | 15.73 (10.09) | 11.62 (7.73) | < 0.001 |
Neutrophil, % | 77.80 (12.16) | 77.43 (12.05) | 80.48 (12.74) | 0.006 |
RBC, m/uL | 4.17 (0.68) | 4.19 (0.68) | 4.04 (0.66) | 0.009 |
Platelet, K/uL | 250.27 (96.86) | 250.25 (95.37) | 250.45 (110.24) | 0.981 |
Hemoglobin, g/dL | 12.67 (2.07) | 12.73 (2.07) | 12.08 (1.97) | < 0.001 |
Serum potassium, mEq/L | 4.22 (0.77) | 4.19 (0.75) | 4.51 (0.88) | < 0.001 |
Serum sodium, mEq/L | 138.23 (4.00) | 138.26 (3.86) | 137.94 (5.16) | 0.346 |
TC, mg/dL | 161.20 (46.30) | 162.37 (45.83) | 149.09 (49.49) | 0.001 |
TG, mg/dL | 132.82 (89.64) | 133.13 (88.04) | 129.92 (103.74) | 0.670 |
LDL, mg/dL | 90.99 (39.95) | 91.97 (39.50) | 80.79 (43.19) | 0.002 |
HDL, mg/dL | 45.05 (14.21) | 45.08 (13.90) | 44.74 (17.17) | 0.790 |
HbA1c, % | 6.45 (1.42) | 6.46 (1.44) | 6.31 (1.15) | 0.413 |
Glucose, mg/dL | 165.39 (86.07) | 162.23 (84.14) | 195.18 (97.85) | < 0.001 |
Albumin, g/dL | 3.49 (0.58) | 3.54 (0.54) | 3.16 (0.70) | < 0.001 |
UCr, mg/dL | 95.46 (65.61) | 97.70 (66.32) | 86.57 (62.36) | 0.215 |
SCr, mg/dL | 1.27 (1.11) | 1.22 (1.08) | 1.67 (1.31) | < 0.001 |
BUN, mg/dL | 24.30 (15.87) | 23.26 (15.17) | 34.04 (18.78) | < 0.001 |
TyG index | 9.14 (0.71) | 9.12 (0.71) | 9.35 (0.73) | < 0.001 |
Correlation between the TyG index and cardiovascular risk factors
Variable | Correlation coefficient | P value |
---|---|---|
Age | − 0.149 | < 0.001 |
Sex, male | − 0.025 | 0.310 |
BMI | 0.074 | 0.025 |
FBG | 0.363 | < 0.001 |
HbA1c | 0.437 | < 0.001 |
TG | 0.760 | < 0.001 |
TC | 0.194 | < 0.001 |
LDL | 0.051 | 0.046 |
HDL | − 0.281 | < 0.001 |
Uric acid | − 0.062 | 0.634 |
Serum creatinine | 0.044 | 0.077 |
Primary outcomes
Categories | Model 1 | Model 2 | Model 3 | ||||||
---|---|---|---|---|---|---|---|---|---|
HR (95% CI) | P-value | P for trend | HR (95% CI) | P-value | P for trend | HR (95% CI) | P-value | P for trend | |
Hospital mortality | |||||||||
Continuous variable per 1 unit | 1.39 (1.13–1.71) | 0.002 | 1.79 (1.35–2.38) | < 0.001 | 1.71 (1.25–2.33) | 0.001 | |||
Quartile a | 0.003 | < 0.001 | 0.004 | ||||||
Q1 (N = 389) | Ref. | Ref. | Ref. | ||||||
Q2 (N = 412) | 1.80 (1.04–3.12) | 0.036 | 1.76 (0.75–4.15) | 0.194 | 1.71 (0.72–4.06) | 0.223 | |||
Q3 (N = 410) | 2.33 (1.39–3.92) | 0.001 | 3.65 (1.73–7.71) | 0.001 | 3.41 (1.59–7.31) | 0.002 | |||
Q4 (N = 407) | 2.25 (1.34–3.77) | 0.002 | 3.50 (1.63–7.53) | 0.001 | 2.88 (1.30–6.39) | 0.009 | |||
ICU mortality | |||||||||
Continuous variable per 1 unit | 1.35 (1.07–1.71) | 0.011 | 1.71 (1.26–2.32) | 0.001 | 1.50 (1.07–2.10) | 0.019 | |||
Quartile | 0.010 | 0.001 | 0.031 | ||||||
Q1 (N = 389) | Ref. | Ref. | Ref. | ||||||
Q2 (N = 412) | 1.79 (0.97–3.31) | 0.063 | 1.87 (0.72–4.86) | 0.198 | 1.77 (0.68–4.62) | 0.246 | |||
Q3 (N = 410) | 2.31 (1.29–4.13) | 0.005 | 4.01 (1.74–9.28) | 0.001 | 3.47 (1.48–8.16) | 0.004 | |||
Q4 (N = 407) | 2.14 (1.19–3.83) | 0.011 | 3.46 (1.46–8.17) | 0.005 | 2.48 (1.01–6.07) | 0.047 |