Predictive Value of Triglyceride-Glucose Index for In-hospital Mortality in Patients With Severe Fever With Thrombocytopenia Syndrome: A Multi-Center Observational Study

Background: Triglyceride-glucose (TyG) index has been proposed as a reliable indicator for insulin resistance and proved to be closely associated with the severity and mortality risk of infectious diseases. It remains indistinct whether TyG index performs an important role in predicting in-hospital mortality in patients with severe fever with thrombocytopenia syndrome (SFTS).Methods: The current study retrospectively recruited patients who were admitted for SFTS from January to December 2019 at five medical centers. TyG index was calculated in accordance with the description of previous study: Ln [fasting triglyceride (TG) (mg/dl) × fasting blood glucose (FBG) (mg/dl)/2]. The observational endpoint of the present study was defined as the in-hospital death.Results: In total, 79 patients (64.9 ± 10.5 years, 39.2% female) who met the enrollment criteria were enrolled in the current study. During the hospitalization period, 17 (21.5%) patients died in the hospital. TyG index remained a significant and independent predictor for in-hospital death despite being fully adjusted for confounders, either being taken as a nominal [hazard ratio (HR) 5.923, 95% CI 1.208–29.036, P = 0.028] or continuous (HR 7.309, 95% CI 1.854–28.818, P = 0.004) variate. TyG index exhibited a moderate-to-high strength in predicting in-hospital death, with an area under the receiver operating characteristic curve (AUC) of 0.821 (95% CI 0.712–0.929, P < 0.001). The addition of TyG index displayed significant enhancement on the predictive value for in-hospital death beyond a baseline model, manifested as increased AUC (baseline model: 0.788, 95% CI 0.676–0.901 vs. + TyG index 0.866, 95% CI 0.783–0.950, P for comparison = 0.041), increased Harrell's C-index (baseline model: 0.762, 95% CI 0.645–0.880 vs. + TyG index 0.813, 95% CI 0.724–0.903, P for comparison = 0.035), significant continuous net reclassification improvement (NRI) (0.310, 95% CI 0.092–0.714, P = 0.013), and significant integrated discrimination improvement (0.111, 95% CI 0.008–0.254, P = 0.040).Conclusion: Triglyceride-glucose index, a novel indicator simply calculated from fasting TG and FBG, is strongly and independently associated with the risk of in-hospital death in patients with SFTS.

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Impact of Albumin-bilirubin (ALBI) score on the Prognostic Significance of Patients with Heart Failure:A Retrospective Cohort Study

10.21203/rs.3.rs-125486/v1 ◽

2020 ◽

Author(s):

Su Han ◽

Chuanhe Wang ◽

Fei Tong ◽

Ying Li ◽

Zhichao Li ◽

...

Keyword(s):

Hospital Mortality ◽

Retrospective Cohort ◽

Poor Prognosis ◽

Prognostic Significance ◽

Continuous Variable ◽

The Other ◽

Hospital Death ◽

Net Reclassification Improvement ◽

C Statistic ◽

Integrated Discrimination Improvement

Abstract Objectives Liver dysfunction is prevalent in heart failure (HF) patients and it can bring a poor prognosis. Presently, albumin-bilirubin (ALBI) score has been designed as an effective and convenient scoring system for assessing liver function, but the correlation linking ALBI and in-hospital mortality in HF patients remains unclear.Methods and Results A total of 9749 patients with HF (from January 2013 to December 2018) was enrolled and retrospectively analyzed. The main outcome is in-hospital death. We examined and analyzed ALBI as a continuous variable as well as according to 3 categories. Following adjustment for multivariable, patients which occurred in-hospital death was remarkably elevated in Tertile 3 group (ALBI>-2.27) (OR=1.670, 95% CI: 1.231~2.265, p=0.001), relative to the other two groups (Tertile 1: <-2.59; Tertile 2: -2.59~-2.27). When ALBI was inspected as a continuous variable, the incidence of HF patients with in-hospital death will increase by 8.2%. (For ALBI score per 0.1 score increasing, OR=1.082, 95% CI: 1.052~1.113, p<0.001). ALBI score for estimating in-hospital mortality under C-statistic was 0.650 (95% CI: 0.641~0.660, p<0.001) and the cut-off value of ALBI score was -2.32 with a specificity of 0.630 and a sensitivity of 0.632. Moreover, ALBI score can enhance the estimation potential of NT-proBNP (NT-proBNP+ALBI vs NT-proBNP: C-statistic: z=1.990, p=0.0467; net reclassification improvement=0.4012, p<0.001; integrated discrimination improvement= 0.0082, p<0.001). Conclusions In patients with HF, ALBI score was an independent prognosticator of in-hospital death. The predictive significance of NT-proBNP +ALBI was superior to NT-proBNP, and ALBI score can enhance the estimation potential of NT-proBNP.

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In-Hospital Mortality in Non-COVID-19-Related Diseases before and during the Pandemic: A Regional Retrospective Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182010886 ◽

2021 ◽

Vol 18 (20) ◽

pp. 10886

Author(s):

Nicola Bartolomeo ◽

Massimo Giotta ◽

Paolo Trerotoli

Keyword(s):

Public Health ◽

Hospital Mortality ◽

Hospital Death ◽

Age Group ◽

Multivariable Logistic Regression Model ◽

Public And Private ◽

Risk Of Death ◽

Hospitalization Period ◽

Public And Private Hospitals ◽

Group Sex

Italy was one of the nations most affected by SARS-CoV-2. During the pandemic period, the national government approved some restrictions to reduce diffusion of the virus. We aimed to evaluate changes in in-hospital mortality and its possible relation with patient comorbidities and different restrictive public health measures adopted during the 2020 pandemic period. We analyzed the hospital discharge records of inpatients from public and private hospitals in Apulia (Southern Italy) from 1 January 2019 to 31 December 2020. The study period was divided into four phases according to administrative restriction. The possible association between in-hospital deaths, hospitalization period, and covariates such as age group, sex, Charlson comorbidity index (CCI) class, and length of hospitalization stay (LoS) class was evaluated using a multivariable logistic regression model. The risk of death was slightly higher in men than in women (OR 1.04, 95% CI: 1.01–1.07) and was lower for every age group below the >75 years age group. The risk of in-hospital death was lower for hospitalizations with a lower CCI score. In summary, our analysis shows a possible association between in-hospital mortality in non-COVID-19-related diseases and restrictive measures of public health. The risk of hospital death increased during the lockdown period.

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Mediation effect of obesity on the association between triglyceride-glucose index and hyperuricemia in Chinese hypertension adults.

10.21203/rs.3.rs-779315/v2 ◽

2021 ◽

Author(s):

Jin Sun ◽

Yongkang Su ◽

Man Li ◽

Shouyuan Ma ◽

Yan Zhang ◽

...

Keyword(s):

Fasting Blood Glucose ◽

Surrogate Marker ◽

Cross Sectional Study ◽

Han Chinese ◽

Mediation Effect ◽

Cross Sectional ◽

Tyg Index ◽

Triglyceride Glucose Index ◽

The Relationship

Abstract Background and Aims: The triglyceride glucose (TyG) index was regarded as a simple surrogate marker of insulin resistance (IR). It is confirmed that IR was significantly associated with hyperuricemia, and obesity was the risk factor for IR and hyperuricemia. However, the relationship between the TyG index and hyperuricemia and the potential role of obesity in Han Chinese hypertension are not entirely elucidated.Methods and Results： A community-based cross-sectional study was conducted in 4551 hypertension patients aged 40-75 years with clinical and biochemical data. The TyG index was calculated as ln [fasting triglyceride (mg/dl) × fasting blood glucose (mg/dl)/2]. Hyperuricemia was determined as serum uric acid ≥357μmol/L (6 mg/dl) for females and ≥417μmol/L (7 mg/dl) for males. The TyG index was higher in patients with hyperuricemia than in those without (8.99±0.61, 8.70±0.59, P<0.001). The prevalence of hyperuricemia in patients with the lowest (≤8.32), second (8.33-8.66), third (8.67-9.07) and the highest quartile (≥9.08) of the TyG index was 6.0%, 10.4%, 15.4%, 21.4%, respectively. Logistic regression analysis suggested that the higher quartile of TyG index was associated with increased hyperuricemia risk whether in crude or adjusted models (P<0.05). Mediation analysis showed that all of our obesity indexes partially mediated the association between the TyG index and hyperuricemia to some extent.Conclusion：TyG index is significantly associated with hyperuricemia in hypertension patients among Han Chinese, obesity plays a partial mediation role in this relationship.

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Predictive Value of Lactate Dehydrogenase to Albumin Ratio (LAR) in Patients With Coronavirus Disease 2019 (COVID-19)

10.21203/rs.3.rs-143788/v1 ◽

2021 ◽

Author(s):

Mingqing Liu ◽

Luping Zhang ◽

Yingli Zhang ◽

Xiaoming Xu ◽

Tantan Ma ◽

...

Keyword(s):

Lactate Dehydrogenase ◽

Hospital Mortality ◽

Disease Severity ◽

Predictive Value ◽

Hospital Death ◽

Albumin Ratio ◽

Acute Infectious Disease ◽

Critical Patients ◽

Wbc Count

Abstract BackgroundCoronavirus Disease-2019 (COVID-19) is an emerging acute infectious disease that was first discovered in Wuhan, Hubei Province, China. Since then, it has quickly spread to over one hundred cities around the world. Therefore, it is crucial to identify the risk factors of in-hospital mortality and disease severity for COVID-19 patients. MethodsWe firstly proposed a biomarker ratio, lactate dehydrogenase(LDH) to albumin ratio (LAR) may be more reliable to assess the predictive value of LAR for in-hospital mortality and early identification of critical COVID-19 patients. A retrospective study was conducted including patients (≥18 years old) with laboratory-confirmed COVID-19 infection who had been discharged or had died from 1 February to 29 February, 2020. ResultsThe study included 321 patients with COVID-19. The median age of the 321 patients was 63.0 (IQR 51.0-70.0), ranging from 19 to 95 years old and 180 (56.1%) patients were male. 142 (44.2%) patients had 1 or more coexisting comorbidity. The most common symptoms on admission were fever(289[90%]) and cough(258[80.4%]). In multivariable logistic regression, only older age (OR, 1.11; 95% CI, 1.05-1.16), WBC count (OR, 1.26; 95% CI, 1.11-1.44), lymphocyte count (OR, 0.78; 95% CI, 0.62-0.99) and LAR (OR, 1.29; 95% CI, 1.18-1.40) were found to be significantly associated with in-hospital death. ROC analysis showed that LAR had a higher AUC (0.917) and the highest specificity(84.0%) and sensitivity(84.6%). Furthermore, the results showed that LAR had a higher AUC (0.931) to differentiate critical from mild patients and had a sensitivity of 87.7% and a specificity of 82.1%. Besides, LAR had an AUC (0.861) to differentiate critical from severe patients and had a sensitivity of 86.0% and a specificity of 73.8% and the role of LAR to distinguish severe from mild patients was the worst. ConclusionsTo the best of our knowledge, this study is the first for us to explore the predictive value of LAR for in-hospital mortality and disease severity. A high LAR appears to predict higher odds of mortality and differentiate critical patients from mild or severe COVID-19 patients.

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BNP and Admission Glucose as In-Hospital Mortality Predictors in Non-ST Elevation Myocardial Infarction

The Scientific World JOURNAL ◽

10.1100/2012/397915 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Julio Yoshio Takada ◽

Rogério Bicudo Ramos ◽

Solange Desiree Avakian ◽

Soane Mota dos Santos ◽

José Antonio Franchini Ramires ◽

...

Keyword(s):

Myocardial Infarction ◽

Hospital Mortality ◽

Predictive Value ◽

Area Under The Curve ◽

St Elevation Myocardial Infarction ◽

Hospital Death ◽

Coronary Syndromes ◽

St Elevation ◽

Independent Risk Factors

Objectives. Admission hyperglycemia and B-type natriuretic peptide (BNP) are associated with mortality in acute coronary syndromes, but no study compares their prediction in-hospital death.Methods. Patients with non-ST-elevation myocardial infarction (NSTEMI), in-hospital mortality and two-year mortality or readmission were compared for area under the curve (AUC), sensitivity (SEN), specificity (SPE), positive predictive value (PPV), negative predictive value (NPV), and accuracy (ACC) of glycemia and BNP.Results. Respectively, AUC, SEN, SPE, PPV, NPV, and ACC for prediction of in-hospital mortality were 0.815, 71.4%, 84.3%, 26.3%, 97.4%, and 83.3% for glycemia = 200 mg/dL and 0.748, 71.4%, 68.5%, 15.2%, 96.8% and 68.7% for BNP = 300 pg/mL. AUC of glycemia was similar to BNP (P=0.411). In multivariate analysis we found glycemia ≥200mg/dL related to in-hospital death (P=0.004). No difference was found in two-year mortality or readmission in BNP or hyperglycemic subgroups.Conclusion. Hyperglycemia was an independent risk factor for in-hospital mortality in NSTEMI and had a good ROC curve level. Hyperglycemia and BNP, although poor in-hospital predictors of unfavorable events, were independent risk factors for death or length of stay >10 days. No relation was found between hyperglycemia or BNP and long-term events.

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Predictive risk score model for severe fever with thrombocytopenia syndrome mortality based on qSOFA and SIRS scoring system

10.21203/rs.2.18479/v2 ◽

2020 ◽

Author(s):

Li Wang ◽

Zhiqiang Zou ◽

Kun Ding ◽

Chunguo Hou ◽

Song Qin

Keyword(s):

Risk Factors ◽

Hospital Mortality ◽

Risk Score ◽

Predictive Value ◽

Multivariable Logistic Regression Analysis ◽

Predictive Values ◽

Independent Risk Factors ◽

Score Model ◽

Qsofa Score ◽

Severe Fever

Abstract Background: Severe fever with thrombocytopenia syndrome (SFTS) is a severe systemic virus infectious disease usually having multi-organ dysfunction which resembles sepsis. Methods: Data of 321 patients with laboratory-confirmed SFTS from May 2013 to July 2017 were retrospectively analyzed. Demographic and clinical characteristics, calculated quick sequential organ failure assessment (qSOFA) score and systemic inflammatory response syndrome (SIRS) criteria for survivors and nonsurvivors were compared. Independent risk factors associated with in-hospital mortality were obtained using multivariable logistic regression analysis. Risk score models containing different risk factors for mortality in stratified patients were established whose predictive values were evaluated using the area under ROC curve (AUC). Results: Of 321 patients, 87 died (27.1%). Age ( p <0.001) and percentage numbers of patients with qSOFA≥2 and SIRS≥2 ( p <0.0001) were profoundly greater in nonsurvivors than in survivors. Age, qSOFA, SIRS score and aspartate aminotransferase (AST) were independent risk factors for mortality for all patients. And qSOFA score was the only common risk factor in all patients, those age≥60 years and those enrolled in the intensive care unit (ICU). A risk score model containing all these risk factors (Model1) has high predictive value for in-hospital mortality in these three groups with AUCs (95% CI): 0.919 (0.883-0.946), 0.929 (0.862-0.944) and 0.815 (0.710-0.894), respectively. A model only including age and qSOFA also has high predictive value for mortality in these groups with AUCs (95% CI): 0.872 (0.830-0.906), 0.885(0.801-0.900) and 0.865 (0.767-0.932), respectively. Conclusions: Risk models containing qSOFA have high predictive validity for SFTS mortality.

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The Impact of the Triglyceride-Glucose Index on Poor Prognosis in NonDiabetic Patients Undergoing Percutaneous Coronary Intervention

Frontiers in Endocrinology ◽

10.3389/fendo.2021.710240 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jie Yang ◽

Yi-Da Tang ◽

Yitian Zheng ◽

Chen Li ◽

Qing Zhou ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Cardiovascular Risk ◽

Poor Prognosis ◽

Fasting Blood Glucose ◽

Coronary Intervention ◽

Diabetic Patients ◽

Tyg Index ◽

Triglyceride Glucose Index ◽

Percutaneous Coronary ◽

The Impact

BackgroundThe triglyceride-glucose index (TyG index) is a valuable marker for predicting adverse cardiovascular events in diabetic patients. However, for nondiabetic patients, whether the TyG index is independently related to poor prognosis remains unclear. This cohort study assessed the association of the TyG index with future cardiovascular risk in nondiabetic subjects who received percutaneous coronary intervention (PCI).MethodsWe consecutively enrolled 5,489 nondiabetic patients who underwent PCI. All experimental subjects were divided into three groups based on their TyG index, which was determined by the equation ln (fasting triglyceride (mg/dl) × fasting blood glucose (mg/dl)/2). The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), including all-cause death, nonfatal myocardial infarction (MI), nonfatal stroke, and target vessel revascularization (TVR).ResultsA total of 386 MACCE were documented during a median 29-month follow-up. The Kaplan–Meier survival results indicated that among the three groups, there was no obvious difference in any endpoints. Further Cox regression analyses suggested that the TyG index was not independently related to adverse cardiovascular outcomes for nondiabetic patients who underwent PCI (HR: 0.77, 95% CI 0.56–1.16, P = 0.210 for MACCE). Subgroup analysis suggested that the TyG index was independently relevant to MACCE for patients with low-density lipoprotein cholesterol (LDL-C) lower than 1.8 mmol/L.ConclusionThe TyG index is not an effective predictive factor for adverse cardiovascular prognosis in nondiabetic patients who underwent PCI. However, in subjects with LDL-C lower than 1.8mmol/L, it may predict future cardiovascular risk.

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Predictive risk score model for severe fever with thrombocytopenia syndrome mortality based on qSOFA and SIRS scoring system

10.21203/rs.2.18479/v3 ◽

2020 ◽

Author(s):

Li Wang ◽

Zhiqiang Zou ◽

Kun Ding ◽

Chunguo Hou

Keyword(s):

Risk Factors ◽

Hospital Mortality ◽

Risk Score ◽

Predictive Value ◽

Multivariable Logistic Regression Analysis ◽

Predictive Values ◽

Independent Risk Factors ◽

Score Model ◽

Qsofa Score ◽

Severe Fever

Abstract Background: Severe fever with thrombocytopenia syndrome (SFTS) is a severe systemic virus infectious disease usually having multi-organ dysfunction which resembles sepsis.Methods: Data of 321 patients with laboratory-confirmed SFTS from May 2013 to July 2017 were retrospectively analyzed. Demographic and clinical characteristics, calculated quick sequential organ failure assessment (qSOFA) score and systemic inflammatory response syndrome (SIRS) criteria for survivors and nonsurvivors were compared. Independent risk factors associated with in-hospital mortality were obtained using multivariable logistic regression analysis. Risk score models containing different risk factors for mortality in stratified patients were established whose predictive values were evaluated using the area under ROC curve (AUC).Results: Of 321 patients, 87 died (27.1%). Age (p<0.001) and percentage numbers of patients with qSOFA≥2 and SIRS≥2 (p<0.0001) were profoundly greater in nonsurvivors than in survivors. Age, qSOFA, SIRS score and aspartate aminotransferase (AST) were independent risk factors for mortality for all patients. And qSOFA score was the only common risk factor in all patients, those age≥60 years and those enrolled in the intensive care unit (ICU). A risk score model containing all these risk factors (Model1) has high predictive value for in-hospital mortality in these three groups with AUCs (95% CI): 0.919 (0.883-0.946), 0.929 (0.862-0.944) and 0.815 (0.710-0.894), respectively. A model only including age and qSOFA also has high predictive value for mortality in these groups with AUCs (95% CI): 0.872 (0.830-0.906), 0.885(0.801-0.900) and 0.865 (0.767-0.932), respectively.Conclusions: Risk models containing qSOFA have high predictive validity for SFTS mortality.

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Change in triglyceride-glucose index predicts the risk of cardiovascular disease in the general population: a prospective cohort study

Cardiovascular Diabetology ◽

10.1186/s12933-021-01305-7 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Anxin Wang ◽

Xue Tian ◽

Yingting Zuo ◽

Shuohua Chen ◽

Xia Meng ◽

...

Keyword(s):

Cardiovascular Disease ◽

General Population ◽

Risk Model ◽

Population Monitoring ◽

Cubic Spline ◽

Baseline Risk ◽

Tyg Index ◽

Net Reclassification Improvement ◽

Triglyceride Glucose Index ◽

The Difference

Abstract Background Previous studies has shown a significant relationship between baseline triglyceride-glucose (TyG) index and subsequent cardiovascular disease (CVD). However, the effect of longitudinal changes in TyG index on the risk of CVD remains uncertain. This study aimed to investigate the association between change in TyG index and the risk of CVD in the general population. Methods The current study included 62,443 Chinese population who were free of CVD. The TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2], and change in TyG index was defined as the difference between the TyG index in 2010 and that in 2006. Multivariable-adjusted Cox proportional hazard models and restricted cubic spline analysis were used to examine the association between change in TyG index and the risk of CVD. Results During a median follow-up of 7.01 years, 2530 (4.05%) incident CVD occurred, including 2018 (3.23%) incident stroke and 545 (0.87%) incident myocardial infarction (MI). The risk of developing CVD increased with the quartile of change in TyG index, after adjustment for multiple potential confounders, the hazard ratios for the Q4 group versus the Q1 group were 1.37 (95% confidence interval [CI], 1.21–1.54) for the overall CVD, 1.38 (95% CI, 1.19–1.60) for stroke, and 1.36 (95% CI, 1.05–1.76) for MI. Restricted cubic spline analysis also showed a cumulative increase in the risk of CVD with increases in the magnitude of change in TyG index. The addition of change in TyG index to a baseline risk model for CVD improved the C-statistics (P = 0.0097), integrated discrimination improvement value (P < 0.0001), and category-free net reclassification improvement value (P < 0.0001). Similar results were observed for stroke and MI. Conclusions Substantial changes in TyG index independently predict the risk of CVD in the general population. Monitoring long-term changes in TyG may assist with in the early identification of individuals at high risk of CVD.

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Comparison of the CAMI-NSTEMI and GRACE Risk Model for Predicting In-Hospital Mortality in Chinese Non-ST-Segment Elevation Myocardial Infarction Patients

Cardiology Research and Practice ◽

10.1155/2020/2469281 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Peng Wang ◽

Hongliang Cong ◽

Ying Zhang ◽

Yujie Liu

Keyword(s):

Myocardial Infarction ◽

Hospital Mortality ◽

Therapeutic Strategy ◽

Risk Model ◽

Accurate Estimation ◽

Hospital Death ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

Net Reclassification Improvement ◽

St Segment

Introduction. The ability of risk models to predict in-hospital mortality and the influence on downstream therapeutic strategy has not been fully investigated in Chinese Non-ST-segment elevation myocardial infarction (NSTEMI) patients. Thus, we sought to validate and compare the performance of the Global Registry of Acute Coronary Events risk model (GRM) and China Acute Myocardial Infarction risk model (CRM) and investigate impacts of the two models on the selection of downstream therapeutic strategies among these patients. Methods. We identified 2587 consecutive patients with NSTEMI. The primary endpoint was in-hospital death. For each patient, the predicted mortality was calculated according to GRM and CRM, respectively. The area under the receiver operating characteristic curve (AUC), Hosmer–Lemeshow (H–L) test, and net reclassification improvement (NRI) were used to assess the performance of models. Results. In-hospital death occurred in 4.89% (126/2587) patients. Compared to GRM, CRM demonstrated a larger AUC (0.809 versus 0.752, p<0.0001), less discrepancy between observed and predicted mortality (H–L χ2: 22.71 for GRM, p=0.0038 and 10.25 for CRM, p=0.2479), and positive NRI (0.3311, p<0.0001), resulting in a significant change of downstream therapeutic strategy. Conclusion. In Chinese NSTEMI patients, the CRM provided a more accurate estimation for in-hospital mortality, and application of the CRM instead of the GRM changes the downstream therapeutic strategy remarkably.

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