U-shaped Association of Admission Fibrinogen Levels with Perihematomal Edema in Hypertensive Intracerebral Hemorrhage
Xu, Z.
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BackgroundPerihematomal edema (PHE) expansion exacerbates neurological outcomes in hypertensive intracerebral hemorrhage (HICH). This study investigates the role of fibrinogen in PHE progression. MethodsWe analyzed 94 HICH patients stratified by fibrinogen quartiles (Q1-Q4). Primary outcome was PHE volume on follow-up imaging. Generalized additive models (GAM) and mixed-effects models evaluated associations between fibrinogen, clinical variables, and edema dynamics. ResultsFibrinogen levels differed significantly across quartiles (P<0.001). The highest quartile (Q4: 29.15{+/-}24.38 mL) exhibited larger edema volumes versus Q1-Q3 (23.70{+/-}14.19 mL). Adjusted models revealed fibrinogen ({beta}=1.32, 95%CI 0.87-1.77), hemoglobin ({beta}=-0.45), aspartate aminotransferase ({beta}=0.21), and apolipoprotein B ({beta}=2.15) as independent predictors (all P<0.05), with model R2=0.41-0.42. Coagulation markers (PTA, D-dimer) and imaging features (blend sign) showed secondary associations. ConclusionElevated fibrinogen independently predicts PHE expansion in HICH, suggesting potential therapeutic targeting of hyperfibrinogenemia.
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