The Relationship of Elevated Hepatic Fibrosis-4 Index Score with Pneumonia Severity Index and in Hospital Mortality Among COVID-19 Patients Admitted to Intensive Care Unit

• Published in: Medical journal of Bakirköy Vol. 18; no. 1; pp. 52 - 58
• Main Authors: Demir, Esra, Güngör, Hande, Erdoğan, Cem, Olmuşçelik, Oktay, Çakmak, Rümeysa, Yıldırım, Ayşegül
• Format: Journal Article
• Language: English
• Published: Galenos Yayınevi 01-03-2022
• Subjects: Tıp; İstanbul; Türkiye; liver fibrosis; Coronavirus infection; pneumonia; Koronavirüs enfeksiyonu; pnömoni; prognostic factors; karaciğer fibrozisi; prognostik faktörler
• ISSN: 1305-9319; 1305-9327
• DOI: 10.4274/BMJ.galenos.2022.2021.12-5

Objective: We investigated the relationship hepatic fibrosis-4 (FIB-4) index score calculated in the early period and pneumonia severity index
(PSI) and in-hospital mortality in patients hospitalized in the intensive care unit (ICU) due to new severe acute respiratory syndrome coronavirus-2
infection.
Methods: Seventy six consecutive patients diagnosed with coronavirus disease-2019 (COVID-19), hospitalized in the ICU due to hypoxemia,
and selected consecutively were included. COVID-19 infection was diagnosed using real-time reverse transcription-polymerase chain reaction
(RT-PCR) in nose and throat swab samples. The diagnosis of pneumonia was confirmed by showing typical ground-glass opacities and areas of
subsegmental consolidation in lung computed tomography examinations of patients previously diagnosed with COVID-19 by RT-PCR. Hepatic
FIB-4 index score and PSI score was calculated separately for each patient. In the statistical method, the independent samples t-test and Mann-
Whitney U test were used to compare quantitative data. A chi-square test was used to compare qualitative data.
Results: The FIB-4 value and PSI value were significantly higher (p<0.05) in the mortality group than in the non-mortality group. Also, there was
no significant statistical difference between the two groups in terms of the other laboratory parameters (p>0.05) FIB-4 value was significantly
predictive [under the curve 0.835 (0.742-0.929)] in differentiating patients with and without mortality. For a cut-off value of 5.4, FIB-4 had a
sensitivity of 60.6%, positive predictive of 95.2%, specificity of 97.6%, and negative predictive value of 75.9%
Conclusion: High FIB-4 index and PSI score detected in the early period in patients admitted to the ICU due to COVID-19 seem to be predictors
of in-hospital mortality.