aceTriglyceride-glucose frailty index, metabolic-frailty phenotypes, and mortality in critically ill patients with acute kidney injury: Derivation, interpretation, and external validation
Background Prognosis remains heterogeneous among critically ill patients with acute kidney injury (AKI). We evaluated the triglyceride-glucose frailty index (TyG-FI), a composite of metabolic burden and laboratory-based frailty, for mortality risk characterization, phenotype identification, prediction, and external validation. Methods We included 2230 adults with KDIGO-defined AKI from MIMIC-IV. Associations between TyG-FI and ICU, in-hospital, 28-day, 90-day, and 365-day mortality were assessed using multivaria…
In 2230 MIMIC-IV adults with AKI, higher TyG-FI was independently associated with ICU and 28-day mortality and enabled identification of lower-burden versus high frailty-organ dysfunction phenotypes that reproduced in 1831 eICU patients with high agreement.
The TyG-FI showed limited incremental predictive advantage over FI-Lab alone and reduced discrimination on external validation, with AUROCs dropping to 0.694 and 0.667 in eICU compared to 0.764 and 0.769 internally.
Incremental predictive value of TyG-FI over frailty alone was limited, and external validation showed lower discrimination than internal testing.
Evidence
- Peer-reviewedExperimental Gerontology2026-08-22
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Truvace Impact Record TRV-2026-0862, v1: “Triglyceride-glucose frailty index, metabolic-frailty phenotypes, and mortality in critically ill patients with acute kidney injury: Derivation, interpretation, and external validation.” Truvace, 2026-08-24. /record/TRV-2026-0862 (accessed at citation time). sha256 8bfe8a4ce76cbb56…
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