Triglyceride-to-High-Density Lipoprotein Ratio as a Predictor of 28-Day Mortality Risk in Patients with Sepsis: A Retrospective Cohort Study.

Purpose: To investigate the relationship between the triglyceride-to-high-density lipoprotein ratio (TG/HDL) and 28-day mortality in patients with sepsis, and to provide a new indicator and basis for the prognosis evaluation of patients with sepsis.

Materials and methods: A retrospective cohort study was conducted that included 578 patients who met the Sepsis 3.0 criteria. Data collection encompassed demographic information, vital signs, laboratory test results, comorbidities, treatment interventions, and prognostic outcomes. The TG/HDL measurement was taken within 24 hours of ICU admission. Patients were categorized into a survival group and a 28-day non-survival group. Additionally, they were stratified into quartiles (Q1, Q2, Q3, Q4) based on their TG/HDL levels. A range of statistical methods were employed for data processing and analysis, including t-tests, non-parametric tests, χ2 tests, logistic regression analysis, subgroup analysis, Kaplan-Meier survival curve analysis, and nonlinear regression analysis.

Results: Significant differences were observed between the 28-day mortality and survival groups in age, heart rate, and respiratory rate. TG/HDL quartile analysis showed group differences in multiple parameters and 28-day mortality. Logistic regression indicated that, relative to Q1, Q4 had a significantly elevated 28-day mortality risk (Model 1: OR=3.434, P<0.001; Model 2: OR=4.655, P<0.001; Model 3: OR=2.690, P=0.004), while Q2 and Q3 did not. Subgroup analysis revealed that the TG/HDL-mortality association varied by subgroup. The KM survival curve showed lower Q4 survival, and nonlinear regression confirmed a nonlinear TG/HDL-mortality relationship.

Conclusion: TG/HDL ratio can serve as an independent predict of 28-day mortality. Its nonlinearity and subgroup-specific significance offer crucial insights for clinical prognostic stratification.