ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neurocritical and Neurohospitalist Care
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1602822
Associations Between Triglyceride Glucose-Body Mass Index and 30-Day Mortality in Patients with Hemorrhagic Stroke: analysis of the MIMIC-IV database
Provisionally accepted
Yuexin Lu1,2
Enjie Song2,3Ruilin Chen1,2
Long Jing1,2
Jiahao Tang1,2
Shi Shunan1,2
Ming Wang1,2,3
Shu Wan1,2,3*- 1Zhejiang Chinese Medical University, Hangzhou, China
- 2Zhejiang Hospital, Hangzhou, Zhejiang Province, China
- 3Zhejiang University, Hangzhou, Zhejiang Province, China
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Background: Hemorrhagic stroke (HS), accounting for over 40% of stroke-related deaths, imposes a severe global health burden due to high mortality and disability rates. The triglyceride-glucose-body mass index (TyG-BMI), integrating lipidglucose metabolism and obesity, has shown prognostic value in cardiovascular diseases but remains underexplored in HS populations.Methods: This retrospective cohort study analyzed 413 HS patients from the MIMIC-IV database. Multivariable Cox regression, Kaplan-Meier analysis, and restricted cubic spline models assessed mortality risks at 30-day, 90-day, and 1-year intervals. Subgroup analysis and interaction tests were performed to evaluate the robustness of the results.Results: Compared with the intermediate TyG-BMI group, the low TyG-BMI group exhibited a significantly increased risk of death at 30 days (adjusted hazard ratio [aHR] = 1.836, P = 0.010), 90 days (aHR = 1.694, P = 0.016), and 1 year (aHR = 1.642, P = 0.014). Similarly, the high TyG-BMI group also showed higher mortality risk at 30 days (aHR = 1.584, P = 0.039), 90 days (aHR = 1.571, P = 0.024), and 1 year (aHR = 1.484, P = 0.030). Kaplan-Meier analysis revealed the highest survival rate in the middle tertile group. Restricted cubic spline curve showed a U-shaped relationship emerged between TyG-BMI and mortality. No interactions between TyG-BMI and 字体: 小四, 非加粗 设置格式[f21033]: critically ill 删除[f21033]: critically ill 删除[f21033]: 字体: (默认)Times New Roman 设置格式[f21033]: Compared to the low TyG-BMI group, the intermediate tertile exhibited significantly reduced 30-day mortality risk [adjusted hazard ratio (aHR) = 0.562, P = 0.004].This protective effect of intermediate TyG-BMI persisted in the 90-day (aHR = 0.644, P = 0.017) and 1-year (aHR = 0.681, P = 0.022). High TyG-BMI levels showed no significant difference with mortality compared with Low TyG-BMI group.The Kaplan-Meier analysis revealed that the lowest tertile has the poorest survival rate.
Keywords: Triglyceride glucose-body mass index, hemorrhagic stroke, All-cause mortality, MIMIC-IV database, Intensive Care Unit
Received: 23 Apr 2025; Accepted: 25 Jul 2025.
Copyright: © 2025 Lu, Song, Chen, Jing, Tang, Shunan, Wang and Wan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shu Wan, Zhejiang Hospital, Hangzhou, 310013, Zhejiang Province, China
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