Neuropsychiatric Disease and Treatment (Sep 2022)
Liver Fibrosis is Associated with Clinical Outcomes in Patients with Intracerebral Hemorrhage
Abstract
Jinjin Wang,1,2,* Liheng Bian,1,2,* Anxin Wang,1,2 Xiaoli Zhang,1,2 Dandan Wang,1,2 Ruixuan Jiang,1,2 Wenjuan Wang,1,2 Yi Ju,1,2 Jingjing Lu,1,2 Xingquan Zhao1– 4 1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China; 2China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China; 3Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 4Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xingquan Zhao; Jingjing Lu, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, People’s Republic of China, Email [email protected]; [email protected]: 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
