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Introduction <p>Hemophagocytic lymphohistiocytosis (HLH) is a rare and fatal disease. The Fibrosis-4 (FIB-4) index is a non-invasive score for distinguishing patients with normal/mild elevation of liver transaminase, but its correlation with adult HLH and 30-day mortality is unclear. The aim of this study was to explore the relationship between admission FIB-4 and 30-day mortality in adult patients with HLH.</p> Methods <p>A retrospective investigation of 467 adult patients with HLH was conducted. Logistic regression analysis and receiver operating characteristic (ROC) curves were used to analyze risk factors.</p> Result <p>Of the 467 adult patients with HLH, 145 (31.0%) died. Elevated admission FIB-4 is an independent risk index for 30-day mortality in adult HLH patients and subgroups. The areas under the ROC curve (AUC) of admission FIB-4 for forecasting 30-day Mortality were 0.716 for the total HLH group and 0.751 for the male HLH group. Moreover, the combination of admission FIB-4 and ferritin had the best predictive ability (AUC = 0.753 for the total group and AUC = 0.775 for the male group).</p> Conclusions <p>Admission FIB-4 is an independent, inexpensive, and universally applicable factor for clinicians to recognize high-risk patients with fair value.</p>

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Elevated fibrosis‑4 index is associated with 30-day mortality in adult hemophagocytic lymphohistiocytosis patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月20日

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  • Jun Zhou,
  • Mengxiao Xie,
  • Mingjun Xie,
  • Zhi-Qi Wu Wu,
  • Hua-Guo Xu

摘要

Introduction

Hemophagocytic lymphohistiocytosis (HLH) is a rare and fatal disease. The Fibrosis-4 (FIB-4) index is a non-invasive score for distinguishing patients with normal/mild elevation of liver transaminase, but its correlation with adult HLH and 30-day mortality is unclear. The aim of this study was to explore the relationship between admission FIB-4 and 30-day mortality in adult patients with HLH.

Methods

A retrospective investigation of 467 adult patients with HLH was conducted. Logistic regression analysis and receiver operating characteristic (ROC) curves were used to analyze risk factors.

Result

Of the 467 adult patients with HLH, 145 (31.0%) died. Elevated admission FIB-4 is an independent risk index for 30-day mortality in adult HLH patients and subgroups. The areas under the ROC curve (AUC) of admission FIB-4 for forecasting 30-day Mortality were 0.716 for the total HLH group and 0.751 for the male HLH group. Moreover, the combination of admission FIB-4 and ferritin had the best predictive ability (AUC = 0.753 for the total group and AUC = 0.775 for the male group).

Conclusions

Admission FIB-4 is an independent, inexpensive, and universally applicable factor for clinicians to recognize high-risk patients with fair value.