Admission D-dimer to lymphocyte counts ratio as a novel biomarker for predicting the in-hospital mortality in patients with acute aortic dissection

xu, yansong; Liang, Silei; Zheng, Lirong; Huang, Cuiqing; Luo, Yihuan; Liang, Guanbiao; Wang, Wei

doi:10.1186/s12872-023-03098-x

Cited by 4 publications

(6 citation statements)

References 39 publications

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“…Our study reinforces these findings by demonstrating that an increase in white blood cell count is an independent risk factor for death. Similarly, elevated D-dimer levels have been previously associated with in-hospital major adverse events, and our results align with those of previous investigations [ 25 – 27 ]. We also identified direct bilirubin level and serum phosphorus level as predictor variables in our model, which have received limited attention in prior studies.…”

Section: Discussionsupporting

confidence: 93%

“…These findings suggest potential directions for future research. Unfortunately, we did not include calculated inflammatory indicators such as NLR, MLR, PLR, SII, D dimer/l, and SCI in our model [ 27 – 29 ]. Although these indicators showed differences in univariate logistic and Cox analyses, they were all excluded in the multivariate analyses, contradicting previous research results.…”

Section: Discussionmentioning

confidence: 99%

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Short- and Long-term survival prediction in patients with acute type A aortic dissection undergoing open surgery

Matniyaz,

Luo,

Jiang

et al. 2024

J Cardiothorac Surg

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Background Acute Type A aortic dissection (ATAAD) is a life-threatening cardiovascular disease associated with high mortality rates, where surgical intervention remains the primary life-saving treatment. However, the mortality rate for ATAAD operations continues to be alarmingly high. To address this critical issue, our study aimed to assess the correlation between preoperative laboratory examination, clinical imaging data, and postoperative mortality in ATAAD patients. Additionally, we sought to establish a reliable prediction model for evaluating the risk of postoperative death. Methods In this study, a total of 384 patients with acute type A aortic dissection (ATAAD) who were admitted to the emergency department for surgical treatment were included. Based on preoperative laboratory examination and clinical imaging data of ATAAD patients, logistic analysis was used to obtain independent risk factors for postoperative in-hospital death. The survival prediction model was based on cox regression analysis and displayed as a nomogram. Results Logistic analysis identified several independent risk factors for postoperative in-hospital death, including Marfan syndrome, previous cardiac surgery history, previous renal dialysis history, direct bilirubin, serum phosphorus, D-dimer, white blood cell, multiple aortic ruptures and age. A survival prediction model based on cox regression analysis was established and presented as a nomogram. The model exhibited good discrimination and significantly improved the prediction of death risk in ATAAD patients. Conclusions In this study, we developed a novel survival prediction model for acute type A aortic dissection based on preoperative clinical features. The model demonstrated good discriminatory power and improved accuracy in predicting the risk of death in ATAAD patients undergoing open surgery.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Short- and Long-term survival prediction in patients with acute type A aortic dissection undergoing open surgery

Matniyaz,

Luo,

Jiang

et al. 2024

J Cardiothorac Surg

View full text Add to dashboard Cite

show abstract

“…Our study reinforces these ndings by demonstrating that an increase in white blood cell count is an independent risk factor for death. Similarly, elevated D-dimer levels have been previously associated with in-hospital major adverse events, and our results align with those of previous investigations [25][26][27]. We also identi ed direct bilirubin level and serum phosphorus level as predictor variables in our model, which have received limited attention in prior studies.…”

Section: Discussionsupporting

confidence: 89%

“…These ndings suggest potential directions for future research. Unfortunately, we did not include calculated in ammatory indicators such as NLR, MLR, PLR, SII, D dimer/l, and SCI in our model [27][28][29]. Although these indicators showed differences in univariate logistic and Cox analyses, they were all excluded in the multivariate analyses, contradicting previous research results.…”

Section: Discussionmentioning

confidence: 93%

Short- and Long-term survival prediction in patients with acute type A aortic dissection undergoing open surgery

Matniyaz

Luo

Jiang

et al. 2023

Preprint

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Background: Acute Type A aortic dissection (ATAAD) is a life-threatening cardiovascular disease associated with high mortality rates, where surgical intervention remains the primary life-saving treatment. However, the mortality rate for ATAAD operations continues to be alarmingly high. To address this critical issue, our study aimed to assess the correlation between preoperative laboratory examination, clinical imaging data, and postoperative mortality in ATAAD patients. Additionally, we sought to establish a reliable prediction model for evaluating the risk of postoperative death. Methods: In this study, a total of 384 patients with acute type A aortic dissection (ATAAD) who were admitted to the emergency department for surgical treatment were included. Based on preoperative laboratory examination and clinical imaging data of ATAAD patients, logistic analysis was used to obtain independent risk factors for postoperative in-hospital death. The survival prediction model was based on cox regression analysis and displayed as a nomogram. Results: Logistic analysis identified several independent risk factors for postoperative in-hospital death, including Marfan syndrome, previous cardiac surgery history, previous renal dialysis history, direct bilirubin, serum phosphorus, D-dimer, white blood cell, multiple aortic ruptures and age. A survival prediction model based on cox regression analysis was established and presented as a nomogram. The model exhibited good discrimination and significantly improved the prediction of death risk in ATAAD patients. Conclusions: In this study, we developed a novel survival prediction model for acute type A aortic dissection based on preoperative clinical features. The model demonstrated good discriminatory power and improved accuracy in predicting the risk of death in ATAAD patients undergoing open surgery.

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“… 6 Previous study suggested that D dimer was a potential index for AD, with excellent sensitivity but poor specificity diagnostic performance. 15 Furthermore, since the initiation of TBAD is always followed by a cascade of sterile inflammatory response, several inflammation markers have been studied for the diagnosis of AD. 16 , 17 Among these known biomarkers, NLR may be a potent surrogate for the determination of TBAD as reported by other study and our findings.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Immature Neutrophils Predict Clinical Outcomes in Patients with Uncomplicated Type-B Aortic Dissection After Thoracic Endovascular Aortic Repair

Abu Bokha,

Li,

Song

et al. 2023

IJGM

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Purpose Inflammation is a hallmark of the initial development and progression of aortic dissection. This study aimed to investigate the predictive value of preoperative neutrophils in aorta-related adverse events (AAEs) after thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD). Patients and Methods A total of 80 patients with TBAD undergoing TEVAR were enrolled in our hospital. Preoperative inflammatory markers, including white blood cells (WBCs), neutrophils, neutrophil-to-lymphocyte ratio (NLR) and plasma high-sensitivity C-reactive protein (hs-CRP), were measured. Circulating neutrophil subpopulation was determined by flow cytometry. Kaplan–Meier curve was performed to determine whether neutrophil subsets independently predicted aorta-related adverse events (AAEs) after TEVAR. Results Compared with control group, the prevalence of hypertension and the levels of inflammatory indicators including WBCs, total neutrophils, NLR, immature neutrophils and hs-CRP were significantly higher in TBAD patients. Receiver operating characteristic (ROC) curve showed that NLR, absolute number of total neutrophils and percent CD10 − immature neutrophils had excellent area under curves. During the 18-month follow-up, 16 (20.0%) were reported to occur AAEs, while 4 deaths (5.0%) were documented. Percent immature neutrophil was markedly higher in TBAD patients experiencing AAEs as compared with those without AAEs. Kaplan–Meier curve and Cox regression analysis demonstrated that percent immature neutrophil was the only predictor correlated with the occurrence of AAEs (hazard ratio 7.66, 95% CI: 2.91, 20.17, P = 0.018). Conclusion Increased CD10 − immature neutrophils could act as a potential biomarker related to long-term adverse outcomes in TBAD patients following TEVAR.

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Admission D-dimer to lymphocyte counts ratio as a novel biomarker for predicting the in-hospital mortality in patients with acute aortic dissection

Cited by 4 publications

References 39 publications

Short- and Long-term survival prediction in patients with acute type A aortic dissection undergoing open surgery

Short- and Long-term survival prediction in patients with acute type A aortic dissection undergoing open surgery

Short- and Long-term survival prediction in patients with acute type A aortic dissection undergoing open surgery

Preoperative Immature Neutrophils Predict Clinical Outcomes in Patients with Uncomplicated Type-B Aortic Dissection After Thoracic Endovascular Aortic Repair

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