AUTHOR=Du Juan , Shao Yingzhe , Song Yajun , Wang Kaixin , Yang Xuan , Li Yanfei , Yao Yaobing , Gong Zhe , Jia Yanjie 

TITLE=Fibrinogen-to-albumin ratio percentage: An independent predictor of disease severity and prognosis in anti-N-methyl-D-aspartate receptor encephalitis

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1083752

DOI=10.3389/fneur.2023.1083752

ISSN=1664-2295

ABSTRACT=This retrospective study aimed to investigate the relationship between fibrinogen to albumin ratio percentage (FARP) and disease severity and prognosis in patients with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. Medical records and clinical characteristics from 181 patients with anti-NMDAR encephalitis were included. The modified Rankin scale (mRS) score was used to analyze disease severity and prognosis at admission and discharge, and correlations between FARP, disease severity, and prognosis were analyzed. Receiver operating characteristic (ROC) curves were performed to evaluate the efficiency of FARP in assessing disease severity and prognosis. The enrolled patients were divided into mild-to-moderate and severe groups according to their mRS scores both at admission and discharge. FARP levels were significantly elevated in the severe group compared to the mild-to-moderate group among patients with anti-NMDAR encephalitis both at admission and discharge (admission 6.0 vs 7.40, P<0.001; discharge 6.43 vs 8.18, P<0.001). Indeed, the mRS scores at admission (56 vs 26%, P<0.001) and discharge (26 vs 11%, P=0.006) in the high FARP group were significantly higher than those in the low FARP group. Furthermore, FARP was positively correlated with admission mRS score (r=0.383, p<0.001) and discharge mRS score (r=0.312, p<0.001). In the multivariate analysis, FARP was significantly associated with disease severity (odds ratio [OR]=1.416, 95% confidence interval [CI]=1.117–1.795, P=0.004) and prognosis (OR=1.252, 95% CI=1.010–1.552, P=0.040). FARP-based ROC curves predicted disease severity, with a sensitivity of 0.756, specificity of 0.626, and area under the ROC curve of 0.722 (95% CI=1.117–1.795, P=0.004). The ROC curve predicted the disease prognosis with a sensitivity of 0.756, a specificity of 0.626, and an area under the ROC curve of 0.723 (95% CI=1.010–1.552, P=0.040). Our results indicate that FARP is a novel predictive marker for disease severity and prognosis of anti-NMDAR encephalitis.