FIB-4 Index and Neutrophil-to-Lymphocyte-Ratio as Death Predictor in Coronary Artery Disease Patients

Mutual Effect of Nutritional Status and Inflammatory Processon Mortality after Superficial Artery Intervention: NAPLES Score

Introduction

Superficial femoral artery (SFA) stenosis is a common type of peripheral arterial disease. Percutaneous treatment has similar long amputation rates with open surgery. There are various predictors of worse outcomes in this patient group, such as chronic kidney disease and malnutrition. The NAPLES score (NPS) is simple scoring system which consists of four elements. We aimed to investigate the role of NPS in predicting long-term mortality in patients with SFA stenosis who underwent a percutaneous intervention.

Methods

A total of 567 patients who underwent percutaneous treatment for stenosis of the SFA from January 2012 to December 2020 were enrolled. The primary endpoint was mortality, and the secondary endpoints were in-hospital thrombosis, restenosis, residual stenosis and postintervention complications. The patients were divided into two groups: high NPS (3, 4) and low NPS (0, 1, 2). Each group was evaluated in terms of clinical, laboratory and technical aspects.

Results

The patients with high NPS had a higher rate of mortality (34% vs. 16.3%, p < 0.05), and shorter time to (17.2 ± 14.7 vs. 29.2 ± 19.3 months, p < 0.05). In multivariate analysis, after adjusting for confounding factors, age [hazard ratio (HR): 1.049, 95% confidence interval (CI): 1.025-1.073, p < 0.001], chronic kidney disease (HR: 1.994, 95% CI: 1.347-2.951, p = 0.001), Rutherford class 5-6 (HR: 1.839, 95% CI: 1.195-2.830, p = 0.006), high C-reactive protein values (HR: 1.004, 95% CI: 1.001-1.008, p = 0.022), and estimated higher NPS (HR: 1.748, 95.5 CI: 1.189-2.572, p = 0.005) were shown to be independent risk factors of mortality.

Conclusions

NPS is a simple scoring system that can be used to predict long-term mortality in this group. More strict control of risk factors is required in patients with a high NPS.

FIB-4 index is associated with mortality in critically ill patients with alcohol use disorder: Analysis from the MIMIC-IV database

BACKGROUND

The relationship between fibrosis-4 (FIB-4) index and all-cause mortality in critically ill patients with alcohol use disorder (AUD) is unclear. The present study aimed to investigate the predictive ability of FIB-4 for all-cause mortality in critically ill AUD patients and the association between them.

METHODS

A total of 2528 AUD patients were included using the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. FIB-4 was calculated for each patient using the existing formula. The patients were equally divided into four groups based on the quartiles of FIB-4. Multivariate logistic regression and Cox proportional hazard model were used to evaluate the association of FIB-4 with in-hospital mortality, 28-day mortality and 1-year mortality. Kaplan-Meier curves were used to analyse the incidence of 28-day mortality among four groups.

RESULTS

FIB-4 was positively associated with 28-day mortality of AUD patients with hazard ratio (HR) of 1.354 [95% confidence interval (CI) 1.192-1.538]. There were similar trends in the in-hospital mortality [odds ratio (OR): 1.440, 95% CI (1.239-1.674)] and 1-year mortality [HR: 1.325, 95% CI (1.178-1.490)].

CONCLUSION

Increased FIB-4 is associated with greater in-hospital mortality, 28-day mortality and 1-year mortality in critically ill AUD patients.