Evaluation of four insulin resistance surrogate indicators for predicting short-term mortality in critically ill patients with ischemic stroke: a nationwide retrospective cohort study

Four surrogate indices of IR were positively associated with short-term mortality risk in critically ill patients with IS. Among these indices, TyG and METS-IR demonstrated relatively stronger risk effects, while the AIP exhibited superior effect size and discriminative ability in patients under 60 years of age. In contrast, TyG-BMI displayed comparatively weaker performance both in the overall population and across subgroups. These findings address a critical gap in understanding the comparative utility of surrogate IR indices for assessing short-term mortality risk in severe IS. Routine evaluation of these indices may enhance clinical assessment and inform individualized patient management across different subgroups. Furthermore, incorporating robust indicators such as TyG into clinical risk assessment models could enhance the precision of mortality predictions and facilitate optimized patient management strategies.