Hyperfibrinogenemia is Significantly Associated with an Increased Risk of In-hospital Mortality in Acute Ischemic Stroke Patients

Background: The impact of hyperfibrinogenemia on short-term outcomes after acute ischemic stroke (AIS) is still not well understood. Objective: We investigated the association between hyperfibrinogenemia upon hospital admission and the short-term prognosis of AIS patients. Methods: A total of 3,212 AIS patients enrolled from December 2013 to May 2014 across 22 hospitals in Suzhou city were included in the present study. Hyperfibrinogenemia was defined as having a serum fibrinogen > 4.0g/L. Cox proportional hazard and logistic regression models were used to estimate the effect of hyperfibrinogenemia on all-cause in-hospital mortality and poor discharge outcome (modified Rankin Scale score >= 3) in AIS patients. Results: During hospitalization, 106 patients (3.3%) died from all-cause and 1226 (38.2%) patients experienced poor functional outcome at discharge. Multivariable model adjusted for age, sex, baseline National Institutes of Health Stroke Scale score, white blood cell count and other covariates, showed that hyperfibrinogenemia was associated with a 1.76-fold increase in the risk of in-hospital mortality (hazard ratio [HR] 1.76; 95% confidence interval [CI], 1.10-2.81; P-value=0.019). However, there was no significant association between hyperfibrinogenemia and poor outcome at discharge (adjusted odds ratios[OR] 1.15; 95% CI 0.86-1.53; P-value=0.338). Sensitivity and subgroup analyses also confirmed a significant association between hyperfibrinogenemia and in-hospital mortality. Conclusion: In patients with AIS, hyperfibrinogenemia at the time of admission was independently associated with increased in-hospital mortality.