Association of FIB-4 index and clinical outcomes in critically ill patients with acute kidney injury: a cohort study

Abstract

Background The relationship between fibrosis-4 (FIB-4) index and clinical outcomes in patients with acute kidney injury (AKI) is unclear. We aimed to investigate the association between FIB-4 index and all-cause mortality in critically ill patients with AKI. Methods We used data from the Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC-III) database (v1.4). The FIB-4 score was calculated using the existing formulas. logistic regression model, and Cox proportional hazards model were used to assessed the relationship between the FIB-4 index and in-hospital,28-day and 90-day mortality, respectively. Results A total of 3592 patients with AKI included in the data analysis. 395 (10.99%) patients died during hospitalization and 458 (12.74%) patients died in 28-day. During the 90-day follow-up, 893 (22.54%) patients were dead. An elevated FIB-4 value was significantly associated with increased in-hospital mortality when used as a continuous variable (odds ratio [OR] 1.183, 95% confidence interval [CI] 1.072–1.305, P = 0.002) and as a quartile variable (OR of Q2 to Q4 1.216–1.744, with Q1 as reference). FIB-4 was positively associated with 28-day mortality of AKI patients with hazard ratio (HR) of 1.097 (95% CI 1.008, 1.194) and 1.098 (95% 1.032, 1.167) for 90-day mortality, respectively. Conclusion This study demonstrated the FIB-4 index is associated with clinical outcomes in critically ill patients with acute kidney injury.

A higher FIB‐4 index is associated with an increased incidence of renal failure in the general population

“…[21] Moreover, a recently published study by Shi et al demonstrated that the FIB-4 is also associated with clinical outcomes in critically ill patients with acute kidney injury. [22] Our current study expands the existing literature, which focuses primarily on the predictive ability of FIB-4 regarding liver-related outcomes by demonstrating a mild association between a higher FIB-4 and key extrahepatic events such as renal failure as a composite endpoint and chronic renal failure. Although the association between a higher FIB-4 and the development of renal failure was comparably weak, the results are strengthened by a clear risk increase for renal failure in patients with a higher FIB-4.…”

“…[ 21 ] Moreover, a recently published study by Shi et al demonstrated that the FIB‐4 is also associated with clinical outcomes in critically ill patients with acute kidney injury. [ 22 ]…”

Non-Invasive Liver Fibrosis Scores Are Associated With Contrast-Associated Acute Kidney Injury in Patients Undergoing Elective Percutaneous Coronary Intervention

“…Another multicenter prospective study of patients with stable CAD undergoing elective PCI also concluded that elevated FIB-4 and AAR values were independently associated with cardiovascular death, non-fatal MI, and ischemic stroke; however, these correlations were not observed in high APRI and Forns score groups. 34 Additionally, Shi et al 35 have indicated that higher levels of FIB-4 were significantly associated with increased risks of in-hospital, 28-day, and 90-day mortality. More importantly, elevated LFSs have even been identified as independent risk factors for AKI in patients with coronavirus disease 2019 (COVID-19).…”