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

IF 2.4 3区医学 Q2 HEMATOLOGY

Annals of Hematology Pub Date : 2025-09-20 DOI:10.1007/s00277-025-06623-4

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

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Abstract

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.

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成人噬血细胞淋巴组织细胞增多症患者纤维化- 4指数升高与30天死亡率相关。

简介：噬血细胞性淋巴组织细胞病（HLH）是一种罕见的致命疾病。纤维化-4 （FIB-4）指数是区分肝转氨酶正常/轻度升高患者的无创评分，但其与成人HLH和30天死亡率的相关性尚不清楚。本研究的目的是探讨成年HLH患者入院FIB-4与30天死亡率之间的关系。方法：对467例成年HLH患者进行回顾性调查。采用Logistic回归分析和受试者工作特征（ROC）曲线分析危险因素。结果：467例成人HLH患者中，145例（31.0%）死亡。入院FIB-4升高是成人HLH患者和亚组30天死亡率的独立风险指标。入院FIB-4预测患者30天死亡率的ROC曲线下面积（AUC），在所有HLH组为0.716，在男性HLH组为0.751。其中，入院FIB-4与铁蛋白的联合预测能力最佳（女性组AUC = 0.753，男性组AUC = 0.775）。结论：入院FIB-4是一个独立的、廉价的、普遍适用的临床医生识别高风险患者的公平价值因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Hematology 医学-血液学

CiteScore

5.60

自引率

2.90%

发文量

304

审稿时长

2 months

期刊介绍： Annals of Hematology covers the whole spectrum of clinical and experimental hematology, hemostaseology, blood transfusion, and related aspects of medical oncology, including diagnosis and treatment of leukemias, lymphatic neoplasias and solid tumors, and transplantation of hematopoietic stem cells. Coverage includes general aspects of oncology, molecular biology and immunology as pertinent to problems of human blood disease. The journal is associated with the German Society for Hematology and Medical Oncology, and the Austrian Society for Hematology and Oncology.