Han Yuchen, Jiang Shiyun, Cheng Siyuan, Zhang Lishuai
School of Medicine, Jinan University, No. 613, Huangpu Avenue West, Guangzhou, Guangdong Province, China.
Department of General Medicine, Guangzhou Huangpu District Yonghe Street Community Health Service Center, No.35 Xinye Road, Huangpu District, Guangzhou, Guangdong Province, China.
Eur J Med Res. 2025 Aug 29;30(1):822. doi: 10.1186/s40001-025-03101-5.
Fibrinogen-albumin ratio (FAR) is a reliable indicator of systemic inflammatory status and prognosis in cardiovascular disease. However, there are still few studies on the prognostic value of the FAR in patients with atrial fibrillation (AF). The aim of this study was to assess the relationship between FAR and all-cause mortality in critically ill patients with AF upon Intensive Care Unit admission.
The data used in this study were obtained from the MIMIC-IV database, and patients were divided into four quartile groups based on FAR levels. The main endpoints were all-cause mortality at 365 days; secondary endpoints were at 30, 90 and 180 days. Kaplan-Meier curves were used for intergroup comparisons of FAR quartiles. The association between FAR (continuous or categorical variables) and clinical outcomes was assessed using Cox proportional hazards regression and restricted cubic spline (RCS) models. To further weaken the influence of confounding factors, we performed propensity score matching (PSM) on the primary outcome. After PSM, Cox regression analysis and KM analysis were re-performed.
The cohorts before and after PSM comprised 834 and 650 patients, respectively. Kaplan-Meier analysis showed that, regardless of whether PSM was performed, an increase in FAR was significantly associated with 365-day all-cause mortality (log-rank P < 0.01). The RCS model shows that the association between FAR and all-cause mortality exhibits an approximately linear upward trend. According to Cox proportional hazards model analysis, FAR, as a continuous variable or categorical variable, is associated with a high risk of death.
FAR could be used as a useful tool for evaluating illness severity and informing clinical management in AF patients admitted to the ICU.
纤维蛋白原-白蛋白比值（FAR）是心血管疾病中全身炎症状态和预后的可靠指标。然而，关于FAR在心房颤动（AF）患者中的预后价值的研究仍然很少。本研究的目的是评估入住重症监护病房的重症AF患者中FAR与全因死亡率之间的关系。
本研究使用的数据来自MIMIC-IV数据库，患者根据FAR水平分为四个四分位数组。主要终点是365天的全因死亡率；次要终点是30天、90天和180天的全因死亡率。采用Kaplan-Meier曲线对FAR四分位数进行组间比较。使用Cox比例风险回归和限制立方样条（RCS）模型评估FAR（连续或分类变量）与临床结局之间的关联。为了进一步减弱混杂因素的影响，我们对主要结局进行了倾向评分匹配（PSM）。PSM后，重新进行Cox回归分析和KM分析。
PSM前后的队列分别包括834例和650例患者。Kaplan-Meier分析表明，无论是否进行PSM，FAR的升高均与365天全因死亡率显著相关（对数秩P<0.01）。RCS模型表明，FAR与全因死亡率之间的关联呈现近似线性上升趋势。根据Cox比例风险模型分析，FAR作为连续变量或分类变量，均与高死亡风险相关。
FAR可作为评估入住ICU的AF患者疾病严重程度和指导临床管理的有用工具。
