A new diagnostic strategy with neutrophil counts in patients with suspected aortic dissection in a certain time window

Abstract

Background: Neutrophil counts are increased in aortic dissection (AD) patients. However, the diagnostic value of neutrophil counts has not been validated.Methods: Patients with suspected AD from two clinical centers were retrospectively enrolled from 01/07/2011 to 30/06/2021. Clinical characteristic data, including history, onset time, diagnosis, and neutrophil counts, were collected.Results: A total of 198 of 534 (37.1%) patients were diagnosed with AD. The neutrophil counts were significantly higher in AD patients during the 2 to 24-hour interval after symptom onset. In this time window, increased neutrophil counts had a sensitivity of 95.6%, specificity of 56.1%, negative likelihood ratio of 0.08, and negative predictive value of 95.6%.Conclusions: Neutrophil counts may be useful in risk stratification of patients to rule out aortic dissection if used within 2-24 hours after symptom onset.

Diagnostic accuracy of the aortic dissection detection risk score alone or with D-dimer for acute aortic syndromes: Systematic review and meta-analysis

“…Fig 1 summarises the process of identifying and selecting relevant literature. Of the 2017 citations identified, 13 studies [ 18 – 30 ] investigating ADD-RS alone or ADD-RS in combination with D-dimer met the inclusion criteria. The majority of the articles were excluded primarily on the basis of an inappropriate target population (patients with AAS or not suspected AAS), intervention did not use ADD-RS alone or ADD-RS in combination with D-dimer or an unsuitable publication type (e.g.…”

“…The studies of McLatchie et al [ 23 ] and Yamashita et al [ 30 ] appeared to have much more inclusive eligibility criteria but were rated as having high risk of bias in flow and timing, principally due to a substantial portion of patients not receiving a reference test (imaging or follow-up) [ 23 , 30 ]. Six studies [ 18 – 21 , 23 , 30 ] had at least one unclear risk of bias in the domain of index test (ADD-RS alone or with D-dimer) or the reference standard due to a lack of clarity as to whether the reference standard results were interpreted without knowledge of the index test or vice versa. Although no studies had high applicability concerns, two studies [ 20 , 21 ] were considered to have unclear concerns as details of the reference standard tests were not clearly specified.…”

“…The design and patient characteristics of the 13 included studies [18][19][20][21][22][23][24][25][26][27][28][29][30] are summarised in Table 1. We report the characteristics of the whole study cohort in this table.…”

Predictive value of neutrophil extracellular traps components for 28-day all-cause mortality in patients with cardiac arrest: A pilot observational study

“…Indeed, the predictive value of these components may be linked to the complicated mechanisms underlying the contribution of NETs to postresuscitative vital organ damage (especially brain damage) (9,15,23). Neutrophils are the most abundant type of white blood cells in circulation and constitute the front line of host immune defense, which is closely associated with the diagnosis and outcomes of inflammation-related diseases (31)(32)(33)(34)(35)(36)(37). In addition to the classical defense mechanisms of neutrophils, such as phagocytosis, ROS production, and degranulation, the NETs formed by these cells play a vital role in host immune defense (38,39).…”

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“…The design and patient characteristics of the 13 included studies [18][19][20][21][22][23][24][25][26][27][28][29][30] are summarised in Table 1. We report the characteristics of the whole study cohort in this table.…”