国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

《国家中心数据管理与共享系统操作说明书 —— 研究者部分》

Liver Fibrosis is Associated with Clinical Outcomes in Patients with Intracerebral Hemorrhage

第一作者：Wang Jinjin,Bian Liheng

通讯作者：Zhao Xingquan,Lu Jingjing

liver fibrosis FIB-4 score intracerebral hemorrhage clinical outcomes survival rate

基本信息

  • 负责人：Wang Jinjin,Bian Liheng
  • 数据来源：
  • 论文编号：脑出血登记20210202
  • 发表时间：2022-09-08

2022-09-08

已发表文章

发表杂志：Neuropsychiatric Disease and Treatment

发表类型: Article

影响因子(IF): 2.989

PMID: PMC9467446 Pubmed原文链接 全文下载

主要研究背景及目的

既往研究表明肝硬化与患者脑出血发病风险增加、预后不良有关。肝纤维化是肝硬化等严重肝脏疾病的亚临床表现之一，一些肝纤维化的指标简单易得，近期有研究表明肝纤维化指标与脑梗死后出血转化、脑出血急性期死亡率相关，但是相关研究较少。我们拟进一步探究常用的肝纤维化指标与脑出血病人急性期血肿生长速度以及短期、长期预后的关系。

方法

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.

结论

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.

主要结果

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.