Association between triglyceride glucose-body mass index and all-cause mortality in patients with sepsis: Evidence from a retrospective cohort study

Background Sepsis remains a leading cause of mortality in critically ill patients, necessitating the identification of reliable prognostic markers. The triglyceride glucose-body mass index, which combines lipid and glucose metabolism, may serve as a valuable predictor of long-term outcomes in this population. Methods This study employed a retrospective observational cohort design and analyzed data from the MIMIC-IV database encompassing 2424 septic patients admitted between 2008 and 2019. Patients were categorized into quartiles based on triglyceride glucose-body mass index values. The primary outcomes assessed were all-cause mortality rates at 30, 90, and 180 days as well as 1-year post-admission, and analysis was performed using multivariable Cox proportional hazards models. Results In total, 2424 septic patients meeting the inclusion criteria were finally included in the analyses. Lower triglyceride glucose-body mass index values have been associated with higher long-term mortality outcomes in critically ill septic patients. However, higher triglyceride glucose-body mass index quartiles were associated with a significant reduction in mortality risk at 180 days and 1 year after admission, even after adjustment for potential confounding variables. Patients in the third (hazard ratio: 0.81, 95% confidence interval: 0.67–0.98, p = 0.028) and fourth (hazard ratio: 0.73, 95% confidence interval: 0.56–0.96, p = 0.026) quartiles exhibited significantly lower hazard ratios for mortality than those in the lowest quartile. Notably, no significant associations were observed with 30-day mortality, suggesting that triglyceride glucose-body mass index values are more strongly associated with long-term outcomes. Conclusion In this retrospective cohort study, lower triglyceride glucose-body mass index values were associated with higher long-term mortality in critically ill septic patients. Our findings suggest that the triglyceride glucose-body mass index serves as a useful prognostic marker and can help identify patients at increased risk of mortality. These results highlight a potential association that warrants further investigation in prospective studies to clarify the role of triglyceride glucose-body mass index in sepsis management.