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Updated: May 16, 2026
A Fibrin-Enriched and tPA-Sensitive Photothrombotic Stroke Model
Published on: June 4, 2021
The inflammation-fibrosis combined index as a predictor of prognosis in stroke patients undergoing mechanical
Xiaoping Xu1, Mengting Chen1, Yaojia Xu2
1Department of Neurology, Xishan People's Hospital of Wuxi City, Wuxi, Jiangsu, China.
Background And Purpose:
This study evaluates the novel Inflammation-Fibrosis Combined Index (IFCI) for predicting 90-day functional outcomes post-MT.
Methods:
We conducted a retrospective analysis of 548 consecutive acute ischemic stroke patients treated with MT. The IFCI was derived from the combination of the Fibrosis-4 (FIB-4) index and the systemic immune-inflammation index (SII). The primary outcome was an unfavorable functional outcome (modified Rankin Scale score 3-6) at 90 days. The association between IFCI and the outcome was assessed using multivariable logistic regression and restricted cubic splines.
Results:
Among the 548 patients (mean age 70.6 years, 56.2% male), 275 (50.2%) experienced an unfavorable outcome. In multivariable analysis, each 1-point increase in IFCI was independently associated with a 2.51-fold increased odds ratio of poor outcome (95% confidence interval [CI], 1.69-3.73; P = 0.001). Patients in the highest IFCI quartile had an 8.79-fold increased odds ratio compared to those in the lowest quartile (95% CI, 3.574-21.661; P = 0.001). The IFCI demonstrated superior discriminative ability (area under the curve [AUC] = 0.725) compared to FIB-4 (AUC = 0.683, P = 0.012) and SII (AUC = 0.604, P = 0.001). Adding IFCI to a model containing conventional risk factors significantly improved risk reclassification (continuous net reclassification improvement = 0.533, integrated discrimination improvement = 0.065; both P = 0.001).
Conclusions:
By integrating the marker of inflammation and fibrosis pathways, the IFCI is an independent predictor of 90-day outcome after MT. It provides prognostic value beyond conventional variables and its individual components, and may serve as a useful tool for early risk assessment and patient management.
Insights
The novel Inflammation-Fibrosis Combined Index (IFCI) effectively predicts poor 90-day outcomes after mechanical thrombectomy (MT) for acute ischemic stroke. This new index offers improved risk assessment beyond traditional factors.
Area of Science:
- Neurology
- Cardiovascular Diseases
- Biomarkers
Background:
- Mechanical thrombectomy (MT) is a critical treatment for acute ischemic stroke.
- Predicting functional outcomes post-MT is essential for patient management.
- Existing predictive models may not fully capture complex pathophysiological processes.
Purpose of the Study:
- To evaluate the novel Inflammation-Fibrosis Combined Index (IFCI) for predicting 90-day functional outcomes after MT.
- To assess the independent predictive value of IFCI compared to its components and conventional risk factors.
Main Methods:
- Retrospective analysis of 548 acute ischemic stroke patients treated with MT.
- IFCI derived from Fibrosis-4 (FIB-4) index and systemic immune-inflammation index (SII).
- Multivariable logistic regression and restricted cubic splines used to assess association with unfavorable 90-day functional outcome (modified Rankin Scale score 3-6).
Main Results:
- Each 1-point increase in IFCI independently associated with a 2.51-fold increased odds of poor outcome (P=0.001).
- Highest IFCI quartile showed an 8.79-fold increased odds of poor outcome compared to the lowest (P=0.001).
- IFCI demonstrated superior discriminative ability (AUC=0.725) versus FIB-4 (AUC=0.683) and SII (AUC=0.604), significantly improving risk reclassification.
Conclusions:
- The IFCI, integrating inflammation and fibrosis markers, is an independent predictor of 90-day outcomes post-MT.
- IFCI offers prognostic value beyond conventional variables and individual components.
- IFCI may serve as a valuable tool for early risk stratification and guiding patient management after MT.
