Triglyceride-Glucose Index and 30-Day Mortality in Pediatric Sepsis: A retrospective cohort study based on PIC database

Yi Ding¹Tao Mei^2*

• ¹The Second Hospital of Jilin University, Changchun, China
• ²Changzhou Women and Children's Hospital, Changzhou, China

Background: The triglyceride–glucose (TyG) index is widely recognized as a surrogate marker of insulin resistance and poor prognosis in adults. However, the relationship between the TyG index and outcomes in pediatric sepsis patients remains inadequately characterized. Elucidating this association could illuminate the metabolic dimension of sepsis pathophysiology and provide a simple, cost-effective tool for risk stratification in this vulnerable population. This study aims to investigate the relationship between the TyG index and 30-day mortality in pediatric sepsis and to explore its underlying biological significance. Methods: We conducted a retrospective cohort study and enrolled 149 children who met the diagnostic criteria for sepsis from the PIC database of the Children's Hospital of Zhejiang University between 2010 and 2018. Participants were stratified by TyG level. The primary outcome was 30-day in-hospital all-cause mortality, and the secondary outcome was 30-day ICU all-cause mortality. Cox regression, restricted cubic splines (RCS), and Kaplan–Meier analyses were used to evaluate the association between the TyG index and 30-day mortality in pediatric sepsis patients. Results: Among the 149 children with sepsis, higher TyG index levels were associated with a reduced 30-day mortality rate. In the multivariate Cox regression model, after adjusting for age, gender and key laboratory variables, the TyG index remained independently and negatively correlated with both in-hospital mortality and intensive care unit mortality. Restrictive cubic spline analysis revealed a linear negative correlation between the TyG index and the risk of death. Subgroup analysis indicated that the TyG index had a consistent protective effect across different age groups, genders and treatment subtypes. Although the Kaplan-Meier survival curve observed a trend of higher TyG index being associated with better survival rates, this association did not reach statistical significance in the sample of this study. Conclusions: In pediatric patients with sepsis, a higher TyG index was associated with a lower 30-day mortality rate. This finding suggests that the TyG index shows potential for being related to short-term survival rates in children. Future studies need to further explore the interaction between the TyG index and other potential prognostic factors, and verify its value in larger or more diverse populations.