Fibrinogen-to-red blood cell ratio is associated with disease burden and short-term outcomes in hospitalized patients with gout: comparison with conventional inflammatory indices.

Background: The fibrinogen-to-red blood cell ratio (FRR) has not been evaluated in gout. This study investigated the association of FRR with disease burden, inflammatory status, renal involvement, and short-term prognosis in hospitalized patients with gout, and compared its performance with the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Methods: This single-center retrospective study included 330 consecutive hospitalized patients with gout admitted between January 2024 and August 2025. Patients were stratified into low- and high-FRR groups according to the median FRR. Clinical characteristics, inflammatory markers, renal indicators, and hospitalization outcomes were compared between groups. Correlation analyses, multivariable linear and logistic regression models, and receiver operating characteristic (ROC) analyses were performed. Results: Compared with the low-FRR group, patients with high FRR had more frequent annual flares, a higher prevalence of tophi, more affected joints, higher levels of CRP and ESR, higher white blood cell, neutrophil, and monocyte counts, more frequent proteinuria, longer hospital stay, higher hospitalization costs, and higher 30-day readmission rates (all Conclusion: FRR may serve as a simple adjunctive biomarker associated with disease burden, inflammatory activity, and selected short-term hospitalization outcomes in hospitalized patients with gout.