Objective:

To investigate the association of fibrinogen-to-red blood cell ratio (FRR) with disease burden, inflammatory status, renal involvement, and short-term prognosis in hospitalized patients with gout, and to compare its performance with traditional inflammatory markers.

Approach:

• Study Design: A single-center retrospective study involving 330 hospitalized gout patients from January 2024 to August 2025.
• Data Collection: Clinical characteristics, inflammatory markers, renal indicators, and hospitalization outcomes were compared between low- and high-FRR groups.
• Statistical Analysis: Correlation analyses, multivariable linear and logistic regression models, and receiver operating characteristic (ROC) analyses were performed.

Key Findings:

• Patients with high FRR had more frequent annual flares and higher prevalence of tophi (P < 0.05).
• High FRR was associated with increased levels of CRP, ESR, and white blood cell counts (P < 0.05).
• High FRR correlated with longer hospital stays, higher costs, and increased 30-day readmission rates (P < 0.05).
• FRR showed stronger correlations with CRP and ESR than NLR and PLR (P < 0.05).
• Higher FRR remained independently associated with annual flare frequency, tophi, proteinuria, and 30-day readmission (P < 0.05).

Interpretation:

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.

Limitations:

• The study was retrospective and did not perform formal sample size calculation.
• Conditions affecting fibrinogen or RBC levels could not be uniformly identified.

Conclusion:

FRR may provide a more comprehensive assessment of inflammatory burden and prognostic risk in gout patients.