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73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

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Impact of initial Fibrinogen/Albumin ratio on intrahospital mortality of patients with spontaneous intracerebral haemorrhage

Einfluss der initialen Fibrinogen/Albumin-Ratio auf die intrahospitale Mortalität bei Patienten mit spontaner intrazerebraler Blutung

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  • presenting/speaker Michael Bender - Universitätsklinikum Gießen, Klinik für Neurochirurgie, Gießen, Deutschland
  • Kristin Haferkorn - Universitätsklinikum Gießen, Klinik für Neurochirurgie, Gießen, Deutschland
  • Hanna Gött - Universitätsklinikum Gießen, Klinik für Neurochirurgie, Gießen, Deutschland
  • Marco Stein - Universitätsklinikum Gießen, Klinik für Neurochirurgie, Gießen, Deutschland
  • Eberhard Uhl - Universitätsklinikum Gießen, Klinik für Neurochirurgie, Gießen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocP112

doi: 10.3205/22dgnc422, urn:nbn:de:0183-22dgnc4228

Published: May 25, 2022

© 2022 Bender et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

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Objective: Despite advancement in intensive care medicine, prediction of outcome in patients after intracerebral haemorrhage (ICH) is still limited. Several studies reported the negative prognostic value of increased fibrinogen/albumin ratio (FAR) on patients with cardiovascular disease and ischemic stroke. However, an evaluation of neurosurgical patients does not exist. The aim of the current study was to investigate the impact of the initial FAR for intra-hospital mortality (IHM) in patients with spontaneous ICH.

Methods: All patients with diagnosis of spontaneous ICH from 10/2008 to 12/2017, who were treated at our intensive care unit (ICU) for at least 24 hours and who had fibrinogen as well as albumin level determined on admission, were retrospectively analysed (n=198). The target values of systolic blood pressure were 120 to 140 mmHg and 80 to 120 mmHg for arterial oxygen partial pressure. Demographic data, radiological data, laboratory data on admission, and cardiopulmonary parameters within the first 24 hours were analysed. Binary logistic regression analysis was used to identify independent prognostic factors for IHM.

Results: The total rate of IHM was 35.4% (n=70). Intraventricular haemorrhage (p=0.025), pre-existing medication (p=0.007), higher partial thromboplastin time (p=0.01), higher C-reactive protein/ albumin level (p=0,022) as well as lower level of cholinesterase (p=0,008), albumin (p=0,002), thromboplastin time (p=0,003) and body temperature (p<0.0001) on admission were associated with IHM. Furthermore, advanced age (p<0.0001, odds ratio [OR]=1.07, 95 % confidence interval [CI]:1.03-1.10), lower Glasgow Coma Scale (p<0.0001, OR=0.75, CI=0.67-0.85), larger volume of intracerebral haematoma (p=0.01, OR=1.01, CI=1.01-1.02) and higher FAR (p=0.03, OR=1.16, CI=1.02-1.31) on admission were independent predictors of IHM in a multivariate model. Furthermore, a FAR ratio cut-off value greater than 0.075 was associated with increased intra-hospital mortality (Youden's Index = 0.26, sensitivity = 0.51, specificity = 0.77).

Conclusion: FAR greater 0.075 on admission is significantly associated with IHM in patients with spontaneously ICH, a finding which could be helpful in early determination of further ICU treatment.