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. 2024 Sep 25:12:e18182.
doi: 10.7717/peerj.18182. eCollection 2024.

Preoperative fibrinogen level predicts the risk and prognosis of patients with native valve infective endocarditis undergoing valve surgery

Jia Li #  1 , Junyong Zhao #  2 , Ning Sun  2 , Lijiao Zhang  1 , Qing Su  1 , Wei Xu  1 , Xiaolin Luo  2 , Zhichun Gao  2 , Keting Zhu  1 , Renjie Zhou  1 , Zhexue Qin  2
Affiliations

Preoperative fibrinogen level predicts the risk and prognosis of patients with native valve infective endocarditis undergoing valve surgery

Jia Li et al. PeerJ. .

Abstract

Aim: The aim of this study was to assess the clinical significance and prognostic value of the preoperative fibrinogen (FBG) level in patients with native valve infective endocarditis (NVIE) who underwent valve surgery.

Methods: This retrospective study included a total of 163 consecutive patients who were diagnosed with NVIE and underwent valve surgery from January 2019 to January 2022 in our hospital. The primary endpoint was all-cause mortality.

Results: All-cause mortality was observed in 9.2% of the patients (n = 15). Body mass index (BMI) was lower in the survival group (p = 0.025), whereas FBG (p = 0.008) and platelet count (p = 0.044) were significantly greater in the survival group than in the death group. Multivariate Cox proportional hazards analysis revealed that FBG (HR, 0.55; 95% CI, [0.32-0.94]; p = 0.029) was an independent prognostic factor for all-cause mortality. Furthermore, Kaplan‒Meier survival curve analysis revealed that patients with low FBG levels (<3.28 g/L) had a significantly greater mortality rate (p = 0.034) than did those with high FBG levels (>3.99 g/L). In the trend analysis, the FBG tertiles were significantly related to all-cause mortality in all three adjusted models, and the p values for trend were 0.017, 0.016, and 0.028, respectively.

Conclusion: Preoperative FBG may serve as a prognostic factor for all-cause mortality, and an FBG concentration less than 3.28 g/L was associated with a greater risk of all-cause mortality in NVIE patients undergoing valve surgery.

Keywords: All-cause mortality; Fibrinogen; Native valve infective endocarditis; Prognostic factor; Valve surgery.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1. Study flow chart of patients enrollment.
Figure 2
Figure 2. Kaplan-Meier survival estimates of all-cause mortality in patients with native valve infective endocarditis.
Figure 3
Figure 3. (A) Receiver operating characteristic (ROC) curves of FBG level and PT-INR for predicting all-cause mortality. (B) Receiver operating characteristic (ROC) curves of FBG combined with PT-INR for predicting all-cause mortality.
See this image and copyright information in PMC

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