已发表论文

肝纤维化与脑出血患者的临床结局相关

 

Authors Wang J, Bian L, Wang A, Zhang X, Wang D, Jiang R, Wang W, Ju Y , Lu J, Zhao X 

Received 20 May 2022

Accepted for publication 17 August 2022

Published 8 September 2022 Volume 2022:18 Pages 2021—2030

DOI https://doi.org/10.2147/NDT.S375532

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Yuping Ning

Background: Recent studies have reported the predictive value of liver fibrosis indices for hematoma enlargement in patients with intracerebral hemorrhage (ICH). However, little is known about the precise association between fibrosis and ICH prognosis. Thus, our study was designed to investigate the relevance of liver fibrosis, as evaluated by fibrosis-4 (FIB-4) score and poor outcomes after ICH.
Methods: We used data from a prospective, multi-center and registry-based database. In this study, patients were stratified by the higher cut-off value of a FIB-4 score ≥ 2.67. The two groups of patients were then compared with regard to baseline characteristics, ICH severity and follow-up outcomes. We performed univariable and multivariable logistic regression analysis to determine the prognostic value of a FIB-4 score ≥ 2.67 for major disability or death. Kaplan–Meier survival curves were used to analyze the association between different FIB-4 scores and survival rate.
Results: Our present study included 839 patients from 13 hospitals in Beijing. Participants with FIB-4 scores ≥ 2.67 had a larger baseline hematoma volume and a higher score on the modified Rankin Scale at follow-up (all p values < 0.05). In the logistic regression analysis, liver fibrosis defined by a FIB-4 score ≥ 2.67 was independently associated with poor clinical outcomes at discharge and at 1 year (at discharge: adjusted odds ratio [95% CI] = 1.894 [1.120– 3.202], p = 0.0172; at 1 year: adjusted odds ratio [95% CI] = 1.694 [1.021– 2.809], p = 0.0412). However, this association was not observed at 3 months. During the follow-up period, patients with a FIB-4 score ≥ 2.67 also had a significantly lower survival rate according to Kaplan–Meier survival analysis.
Conclusion: Our study suggests that liver fibrosis defined by a FIB-4 score ≥ 2.67 is associated with poor clinical outcomes and lower survival rates in patients with mild to moderate ICH. These data provide reliable evidence for detecting fibrosis and managing related risk factors to improve prognosis after ICH.
Keywords: liver fibrosis, FIB-4 score, intracerebral hemorrhage, clinical outcomes, survival rate