Triglyceride-glucose index and short-term mortality of adult patients with sepsis: a meta-analysis.

BACKGROUND: The triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, has been associated with outcomes in sepsis, but existing evidence is inconsistent. This meta-analysis aimed to evaluate the association between a high TyG index and short-term mortality in adult patients with sepsis. METHODS: A systematic search of PubMed, Embase, Web of Science, Wanfang, and CNKI was conducted to identify observational studies reporting the association between TyG index and short-term mortality (in-hospital or ≤30-day) in adult sepsis patients. Effect estimates were pooled using a random-effects model accounting for the influence of heterogeneity. RESULTS: Eight retrospective cohort studies involving 14,772 patients were included. Overall, a higher TyG index was associated with increased short-term mortality (odds ratio [OR] 1.72, 95% confidence intervals 1.44-2.04; I² = 53%). Subgroup analyses showed consistent associations across mean age, proportion of men, and diabetic status (non-diabetic vs. mixed populations: p for subgroup difference all > 0.05). The association remained significant regardless of cutoff determination methods, cutoff values, outcome type (in-hospital vs. 28-day mortality), and study quality scores (p for subgroup difference all > 0.05). Meta-regression analyses did not suggest the association was significantly modified by mean age, proportion of men, proportion of diabetic patients, cutoff values of TyG index, or study quality scores (p all > 0.05). CONCLUSIONS: A higher TyG index is associated with an increased risk of short-term mortality in adult patients with sepsis, supporting its potential role as a simple prognostic marker in clinical practice. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD420261389660.