Inflammatory and Metabolic Predictors of Mortality in Pulmonary Thromboembolism: A Focus on the Triglyceride-Glucose Index and Pan-Immune Inflammation Value

Abstract

Objectives: We aimed to evaluate the importance of metabolic and inflammatory markers, specifically the Triglyceride-Glucose Index (TGI) and pan-immune inflammation value (PIV), in predicting mortality among patients diagnosed with pulmonary thromboembolism (PTE). Materials and Methods: A total of 450 patients diagnosed with PTE between December 2018 and December 2023 were included in his study. The diagnosis of PTE was confirmed by clinical presentation, laboratory tests, and imaging studies such as computed tomography pulmonary angiography (CTPA). Data were obtained from medical records, including demographic information, medical history, laboratory results, and clinical outcomes. Results: In terms of age, non-survivors were older on average (66.1 ± 11.8 years) compared to survivors (58.3 ± 12.4 years) (p = 0.03). In terms of gender, 55% of non-survivors and 45% of survivors were male (p = 0.111). Non-survivors had higher BMIs (28.3 ± 5.1) than survivors (25.7 ± 4.5) (p = 0.04). In terms of hypertension, 40% of non-survivors and 30% of survivors had hypertension (p = 0.041). In terms of diabetes, 35% of those who did not survive and 20% of those who survived had diabetes (p = 0.001). In terms of smoking, 25% of non-survivors and 15% of survivors smoke (p = 0.022). In terms of TGI, non-survivors had higher TGI values (12.1 ± 1.5) than survivors (5.9 ± 1.2) (p < 0.001). In terms of PIV, non-survivors had significantly higher PIV (878.2 ± 85.4) than survivors (254.5 ± 61.1) (p < 0.001). The risk factors found to be significantly associated with differentiation in the multiple logistic regression analysis included age, BMI, TGI, and PIV (p = 0.005, p = 0.002, p = 0.013, and 0.022, respectively). As a result, according to ROC analysis for patients who are non-survivors, age, BMI, TGI, and PIV were significant prognostic factors. The cut-off points for these values were >60, >27, >10, and >500, respectively. Conclusions: the TGI and PIV are strong markers for predicting mortality in PTE patients. The independent predictive value of age and BMI further demonstrates their role in risk stratification. We think that high TGI values and PIVs reflect underlying metabolic and inflammatory disorders that may contribute to worse outcomes in these patients.

Keywords: mortality; pan-immune inflammation; pulmonary thromboembolism; triglyceride–glucose index.

Figure 1

ROC analysis results in patients with non-survivors.