Association between fibrinogen levels and prognosis in critically bleeding patients: exploration of the optimal therapeutic threshold.
Background: Severe bleeding is a leading cause of ICU admission and mortality. Fibrinogen plays a crucial role in prognosis, yet optimal thresholds and supplementation targets remain unclear. Method: Patients with major bleeding were extracted from the MIMIC-IV database. Restricted cubic splines (RC...
| Publicado en: | European Journal of Trauma & Emergency Surgery Vol. 51; no. 1; pp. 1 - 15 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
5/23/2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=185422695&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 185422695 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: 5/23/2025 vid: 51 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 185422695 185422695 185422695 10.1007/s00068-025-02886-8 185422695 ppf: 1 ppct: 14 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Association between fibrinogen levels and prognosis in critically bleeding patients: exploration of the optimal therapeutic threshold. aug: au: Ren, Bingkui Zhang, Yuping Chen, Siying Dai, Jinglong Chong, Junci Chang, Zhigang affil: https://ror.org/02jwb5s28 Department of Critical Care Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 100730, Beijing, People's Republic of China sug: subj: Fibrinogen Blood Hemorrhage Prognosis Critical Illness Prognosis Severity of Illness Critically Ill Patients Dietary Supplementation Fibrinogen Therapeutic Use Funding Source Human Multiple Regression Machine Learning Models, Statistical Cox Proportional Hazards Model Survivors Intensive Care Units Odds Ratio Confidence Intervals Retrospective Design Massachusetts Length of Stay Descriptive Statistics One-Way Analysis of Variance Paired T-Tests Kruskal-Wallis Test McNemar's Test Severity of Illness Indices Male Female Middle Age Aged Hospital Mortality Risk Factors Comparative Studies Kaplan-Meier Estimator Dose-Response Relationship Questionnaires Scales Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background: Severe bleeding is a leading cause of ICU admission and mortality. Fibrinogen plays a crucial role in prognosis, yet optimal thresholds and supplementation targets remain unclear. Method: Patients with major bleeding were extracted from the MIMIC-IV database. Restricted cubic splines (RCS) identified the optimal pre-treatment fibrinogen threshold, and propensity score matching adjusted for confounders. Multiple analytical methods, including multivariable regression and machine learning models, were applied. Post-treatment fibrinogen levels were stratified based on guideline recommendations, and Cox regression assessed survival outcomes. Results: Among 7,063 patients (6,666 survivors, 397 non-survivors), RCS analysis revealed a nonlinear relationship between pre-treatment fibrinogen and ICU mortality (P-non-linear < 0.001), with a threshold at 1.3 g/L. Patients with Fib > 1.3 g/L had a significant 28-day survival benefit (OR = 0.65, 95% CI: 0.48–0.87, p < 0.01). Post-treatment stratification showed that fibrinogen ≥ 1.3 g/L was associated with improved survival (p < 0.01). RCS analysis identified an optimal post-treatment target of 2.0–2.5 g/L. Conclusion: Fibrinogen levels are predictive of ICU outcomes in massive hemorrhage. A pre-treatment threshold of 1.3 g/L indicates poor prognosis, while post-treatment levels of 2.0–2.5 g/L may optimize survival. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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