Prognostic significance of the hemoglobin glycation index in critically ill patients with and without diabetes: analysis of the MIMIC-IV database
- 1Department of Critical Care Medicine, The Affiliated Hospital, Jiangsu University
- 2Department of Emergency Medicine, The Affiliated Hospital, Jiangsu University
Abstract
The hemoglobin glycation index (HGI) is associated with poor cardiovascular outcomes and increased in-hospital mortality, but its prognostic value in critically ill patients with different diabetic status remains unexplored. This study aimed to investigate the relationship between HGI and all-cause mortality in critically ill patients with and without diabetes. Clinical data from 6,758 critically ill patients were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients were stratified into 5 groups based on the quintiles of the HGI. The outcomes included in-hospital, 28-day, and 90-day all-cause mortality. Associations between HGI and clinical outcomes were analyzed using Kaplan-Meier survival curves, multivariate Cox regression, and restricted cubic spline (RCS) analysis. Additionally, subgroup analyses were performed according to potential modifiers. The median age of the cohort was 68.00 (56.56–78.86) years, with a male predominance of 56.6%. After adjusting for confounding variables, individuals in quintile 5 of HGI was associated with a significantly lower mortality risk compared to those in quintile 1 in diabetic patients (in-hospital mortality: HR = 0.571, 95% CI 0.363–0.898; 28-day mortality: HR = 0.505, 95% CI 0.329–0.773; 90-day mortality: HR = 0.597, 95% CI 0.418–0.851) and in nondiabetic patients (in-hospital mortality: HR = 0.641, 95% CI 0.464–0.887; 28-day mortality: HR = 0.504, 95% CI 0.374–0.678; 90-day mortality: HR = 0.638, 95% CI 0.499–0.816). Continuous HGI showed a significant independent correlation with in-hospital, 28-day, and 90-day mortality in both of the diabetic and nondiabetic patients. RCS analyses demonstrated a negative linear correlation between HGI and all-cause mortality. Additionally, incorporating HGI into existing models improved both discrimination and reclassification performance. In critically ill patients with and without diabetes, a lower HGI was identified as an independent predictor of elevated in-hospital, 28-day, and 90-day mortality.
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BibTeX
@article{zhang2026prognostic,
title = {{Prognostic significance of the hemoglobin glycation index in critically ill patients with and without diabetes: analysis of the MIMIC-IV database}},
author = {Jinhui Zhang and Chao Song and Zhenkui Hu},
journal = {Scientific Reports},
year = {2026},
month = jul,
doi = {10.1038/s41598-026-61221-2},
url = {https://doi.org/10.1038/s41598-026-61221-2},
note = {CC BY},
}
RIS
TY - JOUR
TI - Prognostic significance of the hemoglobin glycation index in critically ill patients with and without diabetes: analysis of the MIMIC-IV database
AU - Jinhui Zhang
AU - Chao Song
AU - Zhenkui Hu
PY - 2026
DA - 2026/07/01
JO - Scientific Reports
DO - 10.1038/s41598-026-61221-2
UR - https://doi.org/10.1038/s41598-026-61221-2
AB - The hemoglobin glycation index (HGI) is associated with poor cardiovascular outcomes and increased in-hospital mortality, but its prognostic value in critically ill patients with different diabetic status remains unexplored. This study aimed to investigate the relationship between HGI and all-cause mortality in critically ill patients with and without diabetes. Clinical data from 6,758 critically ill patients were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients were stratified into 5 groups based on the quintiles of the HGI. The outcomes included in-hospital, 28-day, and 90-day all-cause mortality. Associations between HGI and clinical outcomes were analyzed using Kaplan-Meier survival curves, multivariate Cox regression, and restricted cubic spline (RCS) analysis. Additionally, subgroup analyses were performed according to potential modifiers. The median age of the cohort was 68.00 (56.56–78.86) years, with a male predominance of 56.6%. After adjusting for confounding variables, individuals in quintile 5 of HGI was associated with a significantly lower mortality risk compared to those in quintile 1 in diabetic patients (in-hospital mortality: HR = 0.571, 95% CI 0.363–0.898; 28-day mortality: HR = 0.505, 95% CI 0.329–0.773; 90-day mortality: HR = 0.597, 95% CI 0.418–0.851) and in nondiabetic patients (in-hospital mortality: HR = 0.641, 95% CI 0.464–0.887; 28-day mortality: HR = 0.504, 95% CI 0.374–0.678; 90-day mortality: HR = 0.638, 95% CI 0.499–0.816). Continuous HGI showed a significant independent correlation with in-hospital, 28-day, and 90-day mortality in both of the diabetic and nondiabetic patients. RCS analyses demonstrated a negative linear correlation between HGI and all-cause mortality. Additionally, incorporating HGI into existing models improved both discrimination and reclassification performance. In critically ill patients with and without diabetes, a lower HGI was identified as an independent predictor of elevated in-hospital, 28-day, and 90-day mortality.
SN - 2045-2322
ER -