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<p>Liver fibrosis is a proposed risk factor for intracerebral hemorrhage (ICH) and a predictor of ICH-related mortality. However, its impact on functional outcomes and hemorrhage location remains unclear. We aimed to investigate whether liver fibrosis is associated with clinical outcomes and hematoma characteristics according to ICH location. Consecutive patients with ICH between July 2012 and November 2023 were retrospectively included. Favorable outcomes were defined as a modified Rankin Scale score of 0 to 1 at 3 months following stroke onset. We elucidated whether liver fibrosis, assessed by the Fibrosis-4 index (FIB-4 index), was associated with prognosis and hematoma volume in the entire ICH cohort, and separately in lobar and non-lobar ICH cohorts. Following screening of 608 consecutive ICH patients, 356 patients with ICH (entire cohort) who met the inclusion criteria (198 [56%] males, median age 73 years), including 69 with lobar ICH and 287 patients with non-lobar ICH, were identified. Similar to the entire ICH cohort, especially in the lobar ICH cohort, the FIB-4 index correlated negatively with favorable outcomes (prevalence ratio (PR) 0.823, 95% confidence interval (CI) 0.692–0.979, <i>p</i> = 0.027) and positively with hematoma volume (unstandardized coefficient 3.914, 95% CI 1.914–5.915, <i>p</i> &lt; 0.001). Conversely, the FIB-4 index was associated with neither prognosis nor hematoma volume in the non-lobar ICH cohort. Liver fibrosis, as assessed by the FIB-4 index, is associated with unfavorable outcomes and hematoma volume in ICH, particularly in lobar ICH.</p><p></p>

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Fibrosis-4 index and prognosis and hematoma volume: association with lobar and non-lobar intracerebral hemorrhage

  • 期刊论文

  • 发表日期：

    2025年12月10日

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  • Takeo Sato,
  • Yuka Tsuchimochi,
  • Yuki Hamada,
  • Kaishi Kukihara,
  • Yutaro Kawabata,
  • Kana Iwamoto,
  • Go Takaguchi,
  • Yujiro Higuchi,
  • Hideki Matsuoka,
  • Hiroshi Takashima

摘要

Liver fibrosis is a proposed risk factor for intracerebral hemorrhage (ICH) and a predictor of ICH-related mortality. However, its impact on functional outcomes and hemorrhage location remains unclear. We aimed to investigate whether liver fibrosis is associated with clinical outcomes and hematoma characteristics according to ICH location. Consecutive patients with ICH between July 2012 and November 2023 were retrospectively included. Favorable outcomes were defined as a modified Rankin Scale score of 0 to 1 at 3 months following stroke onset. We elucidated whether liver fibrosis, assessed by the Fibrosis-4 index (FIB-4 index), was associated with prognosis and hematoma volume in the entire ICH cohort, and separately in lobar and non-lobar ICH cohorts. Following screening of 608 consecutive ICH patients, 356 patients with ICH (entire cohort) who met the inclusion criteria (198 [56%] males, median age 73 years), including 69 with lobar ICH and 287 patients with non-lobar ICH, were identified. Similar to the entire ICH cohort, especially in the lobar ICH cohort, the FIB-4 index correlated negatively with favorable outcomes (prevalence ratio (PR) 0.823, 95% confidence interval (CI) 0.692–0.979, p = 0.027) and positively with hematoma volume (unstandardized coefficient 3.914, 95% CI 1.914–5.915, p < 0.001). Conversely, the FIB-4 index was associated with neither prognosis nor hematoma volume in the non-lobar ICH cohort. Liver fibrosis, as assessed by the FIB-4 index, is associated with unfavorable outcomes and hematoma volume in ICH, particularly in lobar ICH.