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Background: The triglyceride-glucose (TyG) index was significantly associated with insulin resistance (IR). Several studies have validated the effect of TyG index on cerebrovascular disease. However, the value of TyG index in patients with severe stroke requiring ICU admission remains unclear. The aim of this study was to investigate the association between the TyG index and clinical prognosis of critically ill patients with ischemic stroke (IS).
Methods: This study identified patients with severe IS requiring ICU admission from the Medical Information Mart for Intensive Care (MIMIC-IV) database, and divided them into quartiles based on TyG index level. The outcomes included in-hospital mortality and ICU mortality. The association between the TyG index and clinical outcomes in critically ill patients with IS was elucidated using Cox proportional hazards regression analysis and restricted cubic splines.
Results: A total of 733 patients (55.8% male) were enrolled. The hospital mortality and intensive care unit (ICU) mortality reached 19.0% and 14.9%, respectively. Multivariate Cox proportional hazards analysis showed that the elevated TyG index was significantly related to all-cause death. After confounders adjusting, patients with an elevated TyG index had a significant association with hospital mortality (adjusted hazard ratio, 1.371; 95% confidence interval, 1.053-1.784; P = 0.013) and ICU mortality (adjusted hazard ratio, 1.653; 95% confidence interval, 1.244-2.197; P = 0.001). Restricted cubic splines revealed that a progressively increasing risk of all-cause mortality was related to an elevated TyG index.
Conclusion: The TyG index has a significant association with hospital and ICU all-cause death in critically ill patients with IS. This finding demonstrates that the TyG index might be useful in identifying patients with IS at high risk of all-cause death.
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http://dx.doi.org/10.1186/s12933-023-01864-x | DOI Listing |
J Eval Clin Pract
September 2025
Department of General Medicine, Osaka Medical and Pharmaceutical University Hospital, Takatsuki, Osaka, Japan.
Rationale: Physicians sometimes encounter various types of gut feelings (GFs) during clinical diagnosis. The type of GF addressed in this paper refers to the intuitive sense that the generated hypothesis might be incorrect. An appropriate diagnosis cannot be obtained unless these GFs are articulated and inventive solutions are devised.
View Article and Find Full Text PDFUgeskr Laeger
September 2025
Institut for Klinisk Medicin, Københavns Universitet.
Seriously ill patients often fear not death but dying in pain and solitude. This review emphasises setting treatment ceilings and prioritising palliation over unnecessary interventions. Such discussions are best held in calm settings but can be challenging in acute situations.
View Article and Find Full Text PDFThe COVID-19 pandemic required healthcare organizations to rapidly upskill workers to care for critically ill patients. An integrative review focused on the upskilling of nurses during the pandemic identified themes of strategies, benefits, and challenges of rapid upskilling. Understanding the effectiveness, satisfaction, and challenges of upskilling efforts during COVID-19 can help healthcare organizations prepare for future emergencies by improving workforce readiness and response strategies.
View Article and Find Full Text PDFInt J Antimicrob Agents
September 2025
Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmacy, Fudan University, Shanghai, China; National Key Laboratory of Advanced Drug Formulations for Overcoming Delivery Barriers, Fudan University, Shanghai, China. Electronic address:
Background: This study characterized the urinary pharmacokinetics and pharmacodynamics (PK/PD) of linezolid (LNZ) in critically ill patients with renal impairment and nosocomial multidrug-resistant Gram-positive urinary tract infections (UTIs). The aim was to address therapeutic challenges arising from limited treatment options and uncertain urinary excretion, to establish optimized dosing strategies.
Methods: A prospective observational study was conducted in ICU patients with renal impairment.
Farm Hosp
September 2025
Servicio de Farmacia, Hospital Universitario de Toledo, Toledo, Spain.
Objective: To standardize the drug dilutions administered intravenously in a Pediatric Intensive Care Unit and to characterize these dilutions based on their pH, osmolarity, and vesicant nature. This aims to guide the selection of the most appropriate vascular access device, minimizing associated complications, and preserving the patient's venous capital.
Methods: Through a consensus between Pharmacy and Pediatric Services, the most frequently administered intravenous drugs in the Pediatric Intensive Care Unit were selected.