Zhou Jun, Xie Mengxiao, Xie Mingjun, Wu Zhi-Qi Wu, Xu Hua-Guo
Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Jiangsu, Nanjing, China.
Branch of National Clinical Research Center for Laboratory Medicine, Nanjing, China, Jiangsu.
Ann Hematol. 2025 Sep 20. doi: 10.1007/s00277-025-06623-4.
Hemophagocytic lymphohistiocytosis (HLH) is a rare and fatal disease. The Fibrosis-4 (FIB-4) index is a non-invasive score for distinguishing patients with normal/mild elevation of liver transaminase, but its correlation with adult HLH and 30-day mortality is unclear. The aim of this study was to explore the relationship between admission FIB-4 and 30-day mortality in adult patients with HLH.
A retrospective investigation of 467 adult patients with HLH was conducted. Logistic regression analysis and receiver operating characteristic (ROC) curves were used to analyze risk factors.
Of the 467 adult patients with HLH, 145 (31.0%) died. Elevated admission FIB-4 is an independent risk index for 30-day mortality in adult HLH patients and subgroups. The areas under the ROC curve (AUC) of admission FIB-4 for forecasting 30-day Mortality were 0.716 for the total HLH group and 0.751 for the male HLH group. Moreover, the combination of admission FIB-4 and ferritin had the best predictive ability (AUC = 0.753 for the total group and AUC = 0.775 for the male group).
Admission FIB-4 is an independent, inexpensive, and universally applicable factor for clinicians to recognize high-risk patients with fair value.
噬血细胞性淋巴组织细胞增生症（HLH）是一种罕见的致命疾病。Fibrosis-4（FIB-4）指数是一种用于区分肝转氨酶正常/轻度升高患者的非侵入性评分，但它与成人HLH及30天死亡率的相关性尚不清楚。本研究旨在探讨成人HLH患者入院时FIB-4与30天死亡率之间的关系。
对467例成人HLH患者进行回顾性调查。采用逻辑回归分析和受试者工作特征（ROC）曲线分析危险因素。
467例成人HLH患者中，145例（31.0%）死亡。入院时FIB-4升高是成人HLH患者及其亚组30天死亡率的独立风险指标。入院时FIB-4预测30天死亡率的ROC曲线下面积（AUC）在HLH总组中为0.716，在男性HLH组中为0.751。此外，入院时FIB-4与铁蛋白联合使用具有最佳预测能力（总组AUC = 0.753，男性组AUC = 0.775）。
入院时FIB-4是临床医生识别具有相当价值的高危患者的一个独立、廉价且普遍适用的因素。
