Abstract
INTRODUCTION: 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. METHODS: 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. RESULT: 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). CONCLUSIONS: Admission FIB-4 is an independent, inexpensive, and universally applicable factor for clinicians to recognize high-risk patients with fair value.