{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T00:10:09Z","timestamp":1778285409702,"version":"3.51.4"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multiple cardiometabolic indices have been proposed for prognostic assessment, yet their comparative performance in palliative care remains unclear. The triglyceride-glucose body mass index (TyG-BMI) integrates metabolic dysfunction with adiposity, but whether it outperforms traditional lipid-based, inflammatory, and nutritional indices requires systematic evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To comprehensively compare TyG-BMI against eleven established cardiometabolic indices for predicting sepsis, mechanical ventilation requirement, and 30-day mortality in palliative care patients, with specific focus on performance in diabetic subpopulations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>This retrospective cohort included 318 palliative care patients. Twelve indices were calculated: TyG-BMI (primary); lipid-based (AIP, CRI-I, CRI-II, Non-HDL, TG\/HDL); inflammatory (NLR, PLR, SII, MHR); and nutritional (PNI, CAR). ROC analysis compared discriminative ability for sepsis, mechanical ventilation, and 30-day mortality. Subgroup analyses stratified by diabetes mellitus status were performed with interaction testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 318 patients (mean age 67.4\u2009\u00b1\u200914.8 years, 55% male), 121 (38.1%) had diabetes, 58 (18.2%) developed sepsis, 42 (13.2%) required mechanical ventilation, and 30 (9.4%) died within 30 days. TyG-BMI achieved the highest AUCs: 0.84 (95% CI 0.78\u20130.90) for sepsis, 0.82 (0.75\u20130.89) for ventilation, and 0.87 (0.82\u20130.92) for 30-day mortality\u2014significantly superior to all comparator indices (p\u2009&lt;\u20090.001). In multivariate analysis, TyG-BMI independently predicted mortality (OR 2.38 per SD, 95% CI 1.78\u20133.18, p\u2009&lt;\u20090.001). In diabetic patients, TyG-BMI\u2019s discriminative ability was markedly enhanced (mortality AUC 0.92, 95% CI 0.87\u20130.97; OR 2.65, 95% CI 1.88\u20133.74, p\u2009&lt;\u20090.001), while other indices showed minimal performance improvement (interaction p\u2009&lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TyG-BMI demonstrates superior prognostic performance compared to traditional cardiometabolic indices for predicting sepsis and 30-day mortality in palliative care, with exceptional discriminative ability in diabetic patients.<\/jats:p>\n                  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