Fibrinogen to albumin ratio (FAR) is associated with remote diffusion-weighted imaging lesions (RDWILs) and 1-month short-term outcomes in patients with acute intracerebral hemorrhage

Aims

To investigate the associations between fibrinogen to albumin ratio (FAR) and remote diffusion-weighted imaging lesions (RDWILs) as well as 1-month short-term outcomes in patients with acute intracerebral hemorrhage (ICH).

Methods

A total of 229 consecutive patients with acute ICH were retrospectively included from our hospital between January 2022 and February 2024. RDWILs were defined as focal hyperintensities on diffusion-weighted imaging (DWI) while corresponding hypointensities on apparent diffusion coefficient (ADC), located ≥ 10 mm from the primary hemorrhage focus. FAR1 (within 24 h of admission) and FAR2 (3–7 days post-admission) were both collected. Primary analyses assessed relationships of FAR with RDWILs. Secondary analyses assessed the relationships of FAR with poor 1-month functional outcomes (defined as a modified Rankin Scale [mRS] score of 4–6).

Results

This study included 229 patients (mean age 63 years; 65.9 % male). The mean values of FAR1 and FAR2 were 7.1 and 8.1, respectively. RDWILs were detected in 19.7 % of patients, with 17.5 % having poor 1-month functional outcomes. After adjusting for key covariates, multivariate logistic regression revealed: FAR1 (OR=1.137, 95 %CI:1.057–1.223, p < 0.05) and FAR2 (OR=1.198, 95 %CI:1.088–1.320, p < 0.05) independently associated with RDWILs; FAR2 independently associated with poor 1-month outcomes (OR=1.276, 95 %CI:1.109–1.469, p < 0.05).

Conclusions

We found FAR independently correlates with RDWILs and poor 1-month outcomes in acute ICH patients, with its underlying mechanism to be further explored.