PP043
TRIGLYCERIDE–CHOLESTEROL–BODY WEIGHT INDEX AT ADMISSION AND ICU TRANSFER RISK IN OLDER INPATIENTS
Y. Li1,2,*, M. Zhu1
1Department of General Surgery, Department of Hepato-bilio-pancreatic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 2Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
Rationale: We examined whether the triglyceride–cholesterol–body weight index (TCBI), a routine admission nutrition–metabolism marker, can help identify older inpatients at high risk of subsequent ICU transfer.
Methods: This secondary analysis of two multicentre prospective cohorts from three tertiary hospitals included 5,608 non‑emergency patients aged ≥65 years with a 7–30‑day stay. Admission demographics, comorbidities, anthropometry, nutritional status and laboratory data were collected within 24 hours to calculate log‑transformed TCBI (TCBI‑LN), with ICU admission as the primary outcome and ICU stay and hospital costs as secondary outcomes. Associations between TCBI‑LN and ICU transfer were assessed using multivariable logistic regression with stepwise adjustment and restricted cubic spline analysis (RCS), supported by subgroup analyses.
Results: Among 5,608 patients (median age 74 years; 63.1% male), 3.7% were transferred to ICU. TCBI‑LN correlated positively with BMI, calf circumference, handgrip strength, albumin and prognostic nutritional index and negatively with NRS‑2002 and GLIM‑defined malnutrition (all P < 0.05). ICU admission rates across TCBI‑LN quartiles were 2.2%, 6.7%, 3.1% and 2.9% (P < 0.001). In the fully adjusted model, each 1‑unit increase in TCBI‑LN was associated with higher ICU admission risk (OR 2.295, 95% CI 1.864–2.827; P < 0.001), and this inverse‑U relationship was visualized by the RCS curve. An RCS‑derived cut‑off of 8.5 stratified patients into a high‑risk group (TCBI‑LN ≥8.5, ICU admission 30.7%) and a low‑risk group (2.8%; P < 0.001), with similar patterns in most subgroups, whereas TCBI‑LN was not independently related to ICU stay or costs.
Image:
Conclusion: Admission TCBI‑LN provides a simple, routinely available tool to stratify older ward patients for ICU transfer risk and could complement existing ward early‑warning systems after external validation.
Disclosure of Interest: None declared