Is FIB-4 Index an Independent Risk Factor for Hematoma Expansion in Acute Intracerebral Hemorrhage? A Retrospective Multicenter Observational Cohort Study

Background/Objectives: The FIB-4 index is a laboratory test for predicting liver fibrosis. The aim of this study was to investigate the association between FIB-4 index and hematoma expansion in patients with intracerebral hemorrhage (ICH). Methods: A retrospective review was made of the records of 98 consecutive patients with ICH, separated into two groups according to the FIB-4 index: Group 1 (FIB-4 ≤ 2.67) and Group 2 (FIB-4 > 2.67). The demographic data, admission National Institutes of Health Stroke Scale (NIHSS) scores, hematoma volume on admission and follow-up cranial computed tomography (CT) within 72 h of admission, hematoma extension, mortality, and modified Rankin Scale (mRS) scores at discharge and the first follow-up visit were recorded. Results: Group 1 (FIB-4 ≤ 2.67) included 75 patients (28 (37.3%) females, 47 (62.7%) males) and Group 2 (FIB-4 > 2.67) included 23 patients (6 (26.1%) females, 17 (73.9%) males). The results of multivariable regression analysis to evaluate predictors of hematoma expansion showed an independent association of age and FIB-4 index > 2.67 with hematoma expansion. Increasing age was associated with a lower likelihood of hematoma expansion (OR 0.941, 95% CI 0.901–0.983, p = 0.012). A FIB-4 index > 2.67 indicated a markedly increased predisposition to hematoma expansion compared to a FIB-4 index ≤ 2.67 (OR 4.12, 95% CI 1.215–13.980, p = 0.032). Conclusions: The results of this study showed that an elevated FIB-4 index was associated with hematoma expansion. Large-scale prospective studies are needed to confirm this relationship and provide valuable insights for clinical practice.