Fibrinogen consumption is related to intracranial clot burden in acute ischemic stroke: a retrospective hyperdense artery study

Table 3 Independent association of on-admission fibrinogen and clot burden represented by the clot area with severity of symptoms at presentation (NIHSS): summary of multivariate analysis

Independents	GMR (95 % CI)	p value
Model 1
On-admission fibrinogen (by 2.718-fold)^a	0.683 (0.473–0.987)	0.042
Clot area (by 10 mm²)	1.039 (0.999–1.081)	0.054
Symptom onset to image (by 10 min)	0.984 (0.972–0.997)	0.023
Age (by 5 years)	1.507 (1.010–1.093)	0.014
C-reactive protein (by 1 mg/L)	1.092 (1.045–1.142)	<0.001
Serum glucose (by 1 mmol/L)	1.064 (1.007–1.124)	0.027
Proximal vs. distal middle cerebral artery (MCA)	1.454 (1.110–1.904)	0.007
Proximal MCA vs. “non-MCA” artery	1.866 (1.355–2.570)	<0.001
Model 2 (clot area not included; shows just fibrinogen—all other effects similar as in Model 1)
On-admission fibrinogen (by 2.718-fold)^a	0.649 (0.449–0.938)	0.022
Model 3 (fibrinogen not included; shows just clot area—all other effects similar as in Model 1)
Clot area (by 10 mm²)	1.045 (1.005–1.087)	0.028

Ln-transformed NIHSS scores were analyzed and results are presented as geometric means ratio (GMR) with 95 % confidence intervals by unit or level change in an independent
All variables depicted in Table 1 (except for acute treatment, control image finding, final infarct volume and clinical outcome) were tested for at least a trend (p < 0.1) of univariate association with the NIHSS score at presentation. Ln(fibrinogen), clot area, time since symptom onset to imaging (surrogate for admission), age, C-reactive protein, type of the vessel affected, serum glucose and history of heart failure met this criterion, but the last variable was removed from the final model due to p > 0.5. Three models were fitted differing regarding inclusion of both ln(fibrinogen) and clot area (Model 1), or just ln(fibrinogen) (Model 2) or just clot area (Model 3) along with other effects. The interaction terms between ln(fibrinogen) or clot areal and vessel type were highly insignificant
NIHSS National Institutes of Health Stroke Severity scale
^aSince on-admission fibrinogen was ln-transformed (to achieve normality of residuals), the “effect” of on-admission fibrinogen is presented as GMR by 2.718-fold increase

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