Predictive value of hepatic fibrosis-4 index for early neurological deterioration in patients with ischemic stroke after intravenous thrombolysis
10.3760/cma.j.issn.1673-4165.2023.09.003
- VernacularTitle:肝纤维化-4指数对急性缺血性卒中患者静脉溶栓后早期神经功能恶化的预测价值
- Author:
Kejin YIN
1
;
Liqin LUAN
;
Hong SUN
;
Xuejun WANG
;
Jian SUN
;
Chengfang WU
;
Wenbin WANG
;
Xiaoli PANG
Author Information
1. 南京江北医院神经内科 210000
- Keywords:
Ischemic stroke;
Thrombolytic therapy;
Disease progression;
Liver cirrhosis;
Risk factors;
Predictive value of tests
- From:
International Journal of Cerebrovascular Diseases
2023;31(9):652-657
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the correlation between the degree of hepatic fibrosis and early neurological deterioration (END) after intravenous thrombolysis in patients with acute ischemic stroke (AIS) and its predictive value.Methods:Patients with AIS received intravenous thrombolysis at Nanjing Jiangbei Hospital from January 2018 to March 2023 were retrospectively included. Hepatic fibrosis-4 index (FIB-4) was used to evaluate the degree of hepatic fibrosis in patients. FIB-4 ≥ 2.67 was defined as severe hepatic fibrosis. END was defined as an increase of ≥4 from baseline on the National Institutes of Health Stroke Scale (NIHSS) score within 24 h after intravenous thrombolysis. The relevant factors of END were analyzed through univariate analysis and multivariate logistic regression model. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of FIB-4 for END. Results:A total of 313 patients were included, of which 184 (58.8%) were male, aged 64.8±11.8 years old. The median baseline NIHSS score was 6 (interquartile range, 4-9), and the median FIB-4 was 1.76 (interquartile range, 1.28-2.56). Forty-five patients (14.4%) experienced END. Multivariate logistic regression analysis showed that after adjusting for other confounding factors, higher FIB-4 was significantly independently correlated with END (odds ratio 2.121, 95% confidence interval 1.422-3.162; P=0.001). ROC curve analysis shows that FIB-4 has a good predictive value for END (the area under the curve 0.689, 95% confidence interval 0.595-0.784; P=0.001). The optimal cutoff value of FIB-4 was 1.82, and its sensitivity and specificity in predicting END were 71.1% and 54.9%, respectively. Conclusion:FIB-4 has good predictive value for END in patients with AIS after intravenous thrombolysis.
