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<p>This study aimed to investigate the association between the Fibrosis−4 (FIB−4) index and functional outcomes and hemorrhagic complications in patients with large vessel occlusion acute ischemic stroke (LVO-AIS) treated with mechanical thrombectomy (MT). In this single-center retrospective cohort study, we consecutively enrolled patients with LVO-AIS who underwent MT between January 2018 and February 2024. The primary endpoint was poor functional outcome at 90 days (modified Rankin Scale score 3–6). Secondary endpoints included hemorrhagic transformation (HT) and symptomatic intracranial hemorrhage (sICH). Multivariable logistic regression models and restricted cubic spline analyses were used to evaluate the association between FIB−4 index and outcomes after adjusting for potential confounders. Among 421 patients, 254 (60.33%) had poor outcomes, 197 (46.79%) developed HT, and 76 (18.05%) experienced sICH. After adjustment for confounding factors, each unit increase in FIB−4 index was associated with a 38% higher risk of poor outcome (<i>P</i> = 0.013). This association showed significant nonlinearity (P-nonlinear = 0.010), with risk increasing exponentially beyond a FIB−4 threshold of 2.4. Advanced fibrosis (FIB−4 ≥ 2.67) was independently associated with poor outcomes (<i>P</i> = 0.024). FIB−4 index independently predicts poor functional outcomes in LVO-AIS patients. This readily available biomarker may help identify high-risk patients who could benefit from enhanced monitoring and individualized treatment strategies.</p>

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Association of liver fibrosis−4 index with functional outcomes in chinese patients with acute ischemic stroke undergoing mechanical thrombectomy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月16日

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  • Weiwei Gao,
  • Jingjing She,
  • Xinyu Wu,
  • Zhenxin Zeng,
  • Lijuan Cai,
  • Xingyu Chen,
  • Shaofeng Wu,
  • Renjing Zhu

摘要

This study aimed to investigate the association between the Fibrosis−4 (FIB−4) index and functional outcomes and hemorrhagic complications in patients with large vessel occlusion acute ischemic stroke (LVO-AIS) treated with mechanical thrombectomy (MT). In this single-center retrospective cohort study, we consecutively enrolled patients with LVO-AIS who underwent MT between January 2018 and February 2024. The primary endpoint was poor functional outcome at 90 days (modified Rankin Scale score 3–6). Secondary endpoints included hemorrhagic transformation (HT) and symptomatic intracranial hemorrhage (sICH). Multivariable logistic regression models and restricted cubic spline analyses were used to evaluate the association between FIB−4 index and outcomes after adjusting for potential confounders. Among 421 patients, 254 (60.33%) had poor outcomes, 197 (46.79%) developed HT, and 76 (18.05%) experienced sICH. After adjustment for confounding factors, each unit increase in FIB−4 index was associated with a 38% higher risk of poor outcome (P = 0.013). This association showed significant nonlinearity (P-nonlinear = 0.010), with risk increasing exponentially beyond a FIB−4 threshold of 2.4. Advanced fibrosis (FIB−4 ≥ 2.67) was independently associated with poor outcomes (P = 0.024). FIB−4 index independently predicts poor functional outcomes in LVO-AIS patients. This readily available biomarker may help identify high-risk patients who could benefit from enhanced monitoring and individualized treatment strategies.