The association of triglyceride glucose index and postoperative outcome in patients with severe spontaneous intracerebral hemorrhage: a multiple-center cohort study

The triglyceride-glucose (TyG) index, a marker of insulin resistance, reflects combined lipid and glucose dysregulation, which may exacerbate severe spontaneous intracerebral hemorrhage (SSICH) outcomes. The association of TyG index and postoperative outcome of SSICH patients hasn't been extensively studied. This study aimed to investigate whether the high TyG index was associated with increased risk of poor outcomes in SSICH patients. This study included SSICH patients from a multicenter, prospective cohort study in China from September 2019 to December 2022. TyG index was calculated on admission and the 7th day after surgery and all patients were categorized as Q1 to Q4 according to the interquartile ranges (IQRs) of TyG index. The primary outcome was the incidence of major adverse cardiovascular and cerebrovascular events (MACCE) within 180 days after hemorrhage. This study included 761 SSICH patients receiving surgery with a median admission TyG index of 7.2 (IQR, 6.7-7.6). MACCE occurred in 131 (17.2%) patients within 180 days after SSICH. The results showed that a high TyG index is related to a high incidence of 180-day MACCE events (odds ratio, 2.36, per 1 unit; 95% CI: 1.82, 2.06; P < 0.001), and the risk of 180-day MACCE events significantly increased with the TyG index from Q1 to Q4 (P for trend < 0.001). The further analysis of TyG index on the 7th day after surgery reveal the similar results between TyG index and 180-day clinical outcomes (P < 0.001). This study revealed that high TyG index was associated with the risk of poor outcomes in SSICH patients after surgery, which may serve as an effective and stable indicator for clinical monitoring.