ABSTRACT NUMBER: ESOC2026YS265 PROGNOSTIC VALUE OF THE FIB-4 SCORE FOR FUNCTIONAL OUTCOME AFTER ACUTE ISCHEMIC STROKE

Abstract Background and aims The fibrosis-4 (FIB-4) score, a marker initially developed to estimate hepatic fibrosis, reflects systemic metabolic and inflammatory burden and has been associated with cardiovascular outcomes. We aimed to investigate the relationship between FIB-4 score and 3-month functional outcome in patients with acute ischemic stroke. Methods This retrospective single-center study included patients who have experienced acute ischemic stroke. FIB-4 was calculated using age, platelet count, aspartate aminotransferase and alanine aminotransferase. Poor functional outcome was defined as a 3-month modified Rankin Scale (mRS) score of 4–6. Multivariable logistic regression models were used to identify independent predictors of poor outcome. Formal interaction analysis was conducted to evaluate whether the prognostic effect of FIB-4 differed according to the presence of major vascular comorbidities. Results Among 183 patients, 55 (30.1%) had poor functional outcome. Median FIB-4 values were significantly higher in patients with poor functional outcome compared with those with favorable outcome. In multivariable analysis, higher FIB-4 score was independently related to poor outcome. The association between FIB-4 and outcome remained robust after adjustment for thrombectomy and other comorbidities. Higher FIB-4 score is independently associated with poor functional outcome after acute ischemic stroke, regardless of vascular comorbidity status or stroke severity proxies. FIB-4 may represent a simple, non-invasive and accessible biomarker reflecting systemic vulnerability relevant to stroke prognosis. Further prospective studies are needed to clarify the clinical implications of these findings. Conflict of interest Birgül Baştan Tüzün: nothing to disclose. Fatma Damla Kutbe: nothing to disclose