Value of Triglyceride-Glucose (TyG) Index in Predicting Severe Acute Pancreatitis Patients with Acute Pancreatitis in the Emergency Department.

BACKGROUND: Acute pancreatitis (AP) is an inflammatory disease with an increasing worldwide incidence, ranging from mild edematous forms to severe necrotizing stages. Early prediction of disease severity is vital for guiding treatment strategies. AIM: This study aims to evaluate the value of the Triglyceride-Glucose (TyG) index in predicting disease severity in patients diagnosed with AP in the emergency department. METHODS: In this prospective observational study conducted at the Kayseri City Hospital Emergency Department, 165 patients diagnosed with AP between November 15, 2022, and December 15, 2023, were included. Patients were categorized into three groups-mild, moderately severe, and severe AP-according to the Revised Atlanta Classification. The TyG index was calculated using fasting triglyceride and glucose levels at the time of admission. RESULTS: TyG index, glucose, triglyceride, creatinine, and neutrophil-to-lymphocyte ratio (NLR) values were significantly higher in the severe and moderately severe AP groups compared to the mild AP group (p < 0.05). The TyG index was significantly elevated in patients requiring ICU admission and those with systemic inflammatory response syndrome (SIRS) or organ failure. Univariate ordinal regression analysis identified the TyG index as a significant independent predictor of AP severity; each unit increase in the TyG index increased the odds of being in a more severe disease category by 25.58 times (OR: 25.58, 95% CI: 5.43 - 120.55, p < 0.001). CONCLUSION: The TyG index is a low-cost, easily calculable, and independent metabolic biomarker for predicting disease severity and adverse clinical outcomes in AP patients. Utilizing metabolic indicators like the TyG index alongside inflammatory markers in early risk stratification can be a valuable tool for identifying high-risk patients.