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Hyperfibrinogenemia is Significantly Associated with an Increased Risk of In-hospital Mortality in Acute Ischemic Stroke Patients

[ Vol. 14 , Issue. 3 ]

Author(s):

Shoujiang You, Xiaowei Yin, Huihui Liu, Danni Zheng, Chongke Zhong, Huaping Du, Yu Zhang, Hongru Zhao, Chenhong Qiu, Liangfeng Fan, Shaofang Pei, Zhaoxi Ma, Yongjun Cao and Chun-Feng Liu   Pages 242 - 249 ( 8 )

Abstract:


Background: The impact of hyperfibrinogenemia on short-term outcomes after acute ischemic stroke (AIS) is still not well understood.

Objective: We investigated the association between hyperfibrinogenemia upon hospital admission and the short-term prognosis of AIS patients.

Methods: A total of 3,212 AIS patients enrolled from December 2013 to May 2014 across 22 hospitals in Suzhou city were included in the present study. Hyperfibrinogenemia was defined as having a serum fibrinogen>4.0g/L. Cox proportional hazard and logistic regression models were used to estimate the effect of hyperfibrinogenemia on all-cause in-hospital mortality and poor discharge outcome (modified Rankin Scale score≥3) in AIS patients.

Results: During hospitalization, 106 patients (3.3%) died from all-cause and 1226 (38.2%) patients experienced poor functional outcome at discharge. Multivariable model adjusted for age, sex, baseline National Institutes of Health Stroke Scale score, white blood cell count and other covariates, showed that hyperfibrinogenemia was associated with a 1.76-fold increase in the risk of in-hospital mortality (hazard ratio [HR] 1.76; 95% confidence interval [CI], 1.10–2.81; P-value=0.019). However, there was no significant association between hyperfibrinogenemia and poor outcome at discharge (adjusted odds ratios[OR]1.15; 95% CI 0.86–1.53; P-value=0.338). Sensitivity and subgroup analyses also confirmed a significant association between hyperfibrinogenemia and in-hospital mortality.

Conclusion: In patients with AIS, hyperfibrinogenemia at the time of admission was independently associated with increased in-hospital mortality.

Keywords:

Hyperfibrinogenemia, acute ischemic stroke, in-hospital mortality, hospital discharge outcome, stroke, AIS patients.

Affiliation:

Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, The George Institute for Global Health, University of New South Wales, Sydney 2050, NSW, Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou 215123, Department of Neurology, The Affiliated Wujiang Hospital of Nantong University, Suzhou 215200, Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou 215006, Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou 215001, Department of Neurology, Suzhou Kowloon Hospital, Shanghai Jiao Tong University, School of Medicine, Suzhou 215021, Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou 215001, Department of Neurology, Kunshan First People’s Hospital, Suzhou 215300,China; 9Institutes of Neuroscience, Soochow University, Suzhou 215123, Department of Neurology, the Second Affiliated Hospital of Soochow University, No.1055, Sanxiang Road; 215004, Suzhou, Jiangsu, Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou City, Jiangsu 215004



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