What question did this study set out to answer?

To evaluate the predictive power of the FIB-4 index for short-term mortality in acute heart failure patients in Vietnam.

March 13, 2026Open Access

FIB-4 index predicts short-term mortality in Vietnamese acute heart failure patients

Key Result

Each one-point increase in FIB-4 score raised the 30-day mortality risk by 9% in acute heart failure patients, with a cut-off of 3.1 identifying high-risk individuals.

Key Points

To evaluate the predictive power of the FIB-4 index for short-term mortality in acute heart failure patients in Vietnam.
Conducted a prospective cohort study in a single-center setting
Included hospitalized adults with acute heart failure and NT-proBNP levels ≥300 pg/mL
Followed up survivors via phone for 30 days post-discharge
Analyzed associations between FIB-4 scores and 30-day mortality
In-hospital mortality was 5.1%; 30-day mortality in follow-up was 17%
Non-survivors had higher FIB-4 scores (3.3 vs. 2.3, p = 0.006)
Each 1-point increase in FIB-4 increased 30-day mortality risk by 9% (RR 1.09; 95%CI: 1.01–1.17)
A FIB-4 cut-off of 3.1 indicated high-risk patients with RR of 1.82 (95%CI: 1.03–3.22)
FIB-4 showed an AUC of 0.634, comparable to NT-proBNP (AUC 0.650).

Structured PICO

Does the FIB-4 index predict 30-day all-cause mortality in adults hospitalized with acute heart failure?

Population

413 adults aged ≥18 hospitalized with acute heart failure (AHF) and NT-proBNP levels ≥300 pg/mL, mean age 70, 47.7% male. Exclusions included chronic liver disease, active cancer, end-stage renal disease, or death before blood sample collection.

Intervention

FIB-4 index assessment

Outcome

30-day all-cause mortalityhard clinical

The FIB-4 index is independently associated with 30-day mortality in acute heart failure patients, suggesting it may be a useful and accessible tool for short-term risk stratification.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Acute heart failure (AHF) has high early mortality. The FIB-4 index indicates hepatic dysfunction in AHF, but its predictive power for short-term outcomes in developing countries is not well established. We conducted a prospective cohort study at Can Tho Central General Hospital, Vietnam, from May to December 2024 including adults aged ≥18, hospitalized with AHF and NT-proBNP levels ≥300 pg/mL. Exclusions were for those who died before blood sample collection, transferred, declined consent, or had chronic liver disease, active cancer, or end-stage renal disease. Survivors were followed up via phone for 30 days post-discharge. The primary endpoint was 30-day all-cause mortality. The final analysis included 413 patients (mean age 70, 47.7% male). In-hospital mortality was 5.1% and did not associate to FIB-4. At 30 days post-discharge, 42(17%) of 247 patients with follow-up data died (37.3% loss to follow-up). Non-survivors had higher FIB-4 scores than survivors (3.3 vs. 2.3, p = 0.006). After adjusting for age, sex, comorbidities, LVEF, and NT-proBNP, each one-point increase in FIB-4 raised the 30-day mortality risk by 9% (RR 1.09; 95%CI: 1.01–1.17). A cut-off of 3.1 identified high-risk patients, with a RR of 1.82 (95%CI: 1.03–3.22). FIB-4 demonstrated an AUC of 0.634 (95%CI: 0.535–0.733) which was comparable to NT-proBNP (AUC 0.650; 95%CI: 0.559–0.742). In this exploratory single-center study of patients with AHF, FIB-4 demonstrated an independent association with 30-day mortality, with a threshold of 3.1 identifying high-risk individuals. These findings are hypothesis-generating, and external validation is warranted before FIB-4 can be recommended for risk stratification.