OBJECTIVE: This study aimed to evaluate the predictive capability of glycolipid metabolism index (triglyceride-glucose index, TyG
atherogenic index of plasma, AIP
triglyceride to high-density lipoprotein cholesterol ratio, TG/HDL-C
and non-HDL-C to HDL-C ratio, NHHR) for complications and ventilator use in patients with intracerebral hemorrhage (ICH) admitted to the intensive care unit (ICU). METHODS: Patients with ICH requiring ICU admission were selected from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Outcomes assessed included incidence of complications and use of ventilator support. Multivariate logistic regression, receiver operating characteristic (ROC) analysis, and restricted cubic spline were employed to investigate the relationship between glycolipid metabolism index and clinical outcomes in ICH patients. RESULTS: A total of 733 patients were included. Multivariate logistic regression analysis revealed that elevated TyG, AIP, and TG/HDL-C levels were associated with increased incidence of complications and prolonged ventilator use. ROC curve analysis demonstrated that TyG (AUC 0.646) exhibited the strongest predictive ability for multiple complications in ICH patients. Further multiple regression analysis identified TG/HDL-C as an independent predictor of deep vein thrombosis, while TyG, AIP, and TG/HDL-C independently predicted pulmonary embolism, and TyG, AIP, NHHR, and TG/HDL-C independently predicted acute kidney injury. Moreover, ventilator use further heightened the risk of multiple complications in ICU patients with elevated glycolipid metabolism index. CONCLUSION: Glycolipid metabolism index represent promising and readily accessible biomarkers for predicting multiple complications and ventilator use in ICU patients with ICH.