Association of Lymphocyte to Monocyte Ratio and Risk of In-Hospital Mortality in Patients with Acute Type A Aortic Dissection

Lin, Yanjuan; Peng, Yanchun; Li, Sailan; Huang, Xizhen; Zhang, Haoruo; Jiang, Fei; Chen, Qiong

doi:10.2217/bmm-2018-0423

Cited by 31 publications

(27 citation statements)

References 27 publications

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“…Both lymphocyte to monocyte ratio (LMR) and lymphocyte to neutrophil ratio (LNR), obtained from routine blood tests at admission, are readily available inflammatory biomarkers [8,9]. Previous studies have found that LMR and LNR both were good predictors of worse outcomes in patients with AAAD [10,11]. However, the comparative predictive values of LMR and LNR are unclear.…”

Section: Introductionmentioning

confidence: 99%

Relationship of Platelet Counts and Inflammatory Markers to 30-Day Mortality Risk in Patients with Acute Type A Aortic Dissection

Lin

Zhang

Peng

et al. 2020

BioMed Research International

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Markers of prothrombotic state and inflammation are associated with the prognosis of patients with acute type A aortic dissection (AAAD). However, it is unclear that the relationship between these biomarkers and their combined impact on risk stratification. The present study evaluated the prognostic value of platelet counts, lymphocyte to neutrophil ratio (LNR), and lymphocyte to monocyte ratio (LMR), alone and in combination. A retrospective analysis of clinical data of 744 AAAD patients was conducted to identify whether these biomarkers were related to the 30-day mortality risk. A Kaplan-Meier analysis and log-rank test were used to compare survival between groups. A Cox hazard regression multivariable analysis was performed for 30-day mortality. Individual biomarker (platelet count, LNR, or LMR) was unable to predict 30-day mortality. However, combinations of all three biomarkers provided additive predictive value over either marker alone, the receiver operating characteristic (ROC) model had a prediction probability of 0.739 when platelet counts, LNR, and LMR were included. Cox hazard regression multivariable analysis showed that combinations of all three biomarkers were the strongest predictor of 30-day mortality (p<0.021). Combined with these three easily measurable biomarkers at admission, they could help identify AAAD patients with a high risk of 30-day mortality.

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Section: Introductionmentioning

confidence: 99%

Relationship of Platelet Counts and Inflammatory Markers to 30-Day Mortality Risk in Patients with Acute Type A Aortic Dissection

Lin

Zhang

Peng

et al. 2020

BioMed Research International

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“…We hold that our study is distinct and meaningful, although some previous studies have reported better value ROC compared to HCO3 − in our study. 3,4,13 In these studies, the outcomes were in-hospital mortality and hospital complications such as aortic rupture, mechanical ventilation, renal dysfunction and visceral hemorrhage. In contrast, survival time and longer-term mortality (30 days, 90 days, 1 year and 5 years) were set as our outcomes in this study.…”

Section: Discussionmentioning

confidence: 99%

“…2 Hence, identification of simple biomarkers for evaluating the prognosis of AAD plays a vital role in risk stratification in this kind of patient. Previous studies have shown that lymphocyte-to-monocyte ratio (LMR), 3 hypotensive systolic blood pressure, 4 N-terminal pro-brain natriuretic peptide, 5 C-reactive protein, 6 cardiac troponin 7 and serum fibrinogen level 8 were associated with the prognosis of patients with AAD; however, the studies above mainly used in-hospital mortality as outcomes. Effective variables to predict the prognosis of AAD are still lacking in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Association Between the Admission Serum Bicarbonate and Short-Term and Long-Term Mortality in Acute Aortic Dissection Patients Admitted to the Intensive Care Unit

Tan¹,

Xu²,

Li³

et al. 2021

IJGM

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Objective: Serum bicarbonate (HCO3 − ) level is strongly related to multiple cardiovascular complications. Currently, there is no study evaluating the prognostic ability of serum HCO3 − level in intensive care unit (ICU) patients with acute aortic dissection (AAD). Hence, this study was to assess the relationship between admission serum HCO3 − level and clinical outcomes in patients with AAD. Design, Settings and Participants: Clinical data were extracted from the MIMIC-III database. Cox proportional hazards models and Kaplan-Meier (KM) survival curve were used to evaluate the association between serum HCO3 − levels and short-and long-term mortality in ICU patients with AAD. The subgroup analysis and the receiver operating characteristic (ROC) curve analysis and further KM survival curve based on best cut-off value were applied to assessment of the performance of HCO3 − in predicting the mortality in each period (30 days, 90 days, 1 year and 5 years). Main Results: Firstly, 336 eligible patients were trisected to low-HCO3 − level group (<22 mmol/L), mid-HCO3 − level group (22-24 mmol/L) and high-HCO3 − level group (>24 mmol/L). Then, in multivariate analysis, the serum HCO3 − of low levels (<22 mmol/ L) was a significant risk predictor of all-cause mortality in 30 days, 90 days, 1 year and 5 years. Subgroup analyses indicated that there is no interaction in most strata. Finally, areas under ROC curve ranged from 0.60 to 0.69. Conclusion:The low HCO3 − serum level measured at ICU admission significantly predicts short-term and long-term mortality in AAD patients.

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“…The coagulation system is activated by extensive in ammation and the reverse is also true via crosstalk 16 . Attention have been focused on the prognostic value of individual indicators such as MLR and NLR for ATAAD in previous studies 17,18 , which is unable to obtain an ideal prediction e cacy. New research demonstrates that ATAAD results from a combination of in ammation and thrombosis 19 .…”

Section: Disscussionmentioning

confidence: 99%

Efficacy of CRP In Combination With D-Dimer In Predicting Adverse Postoperative Outcomes of Patients With Acute Stanford Type A Aortic Dissection

Tang

et al. 2021

Preprint

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Objectives: The present study aimed to evaluate the efficacy of CRP and D-dimer and the combination of them as prognostic indicators for patients with acute type A aortic dissection (ATAAD).Methods: This is a retrospective cohort study. From January 2017 to December 2020, all consecutive patients with ATAAD admitted to the emergency medicine center of our hospital within 24 hours after symptoms (chest pain, back pain, abdominal pain and so on) onset were enrolled in our study. Serum concentration of CRP and D-dimer were measured on admission. The univariate and multivariate logistic regression analyses were used to identify these predictors of adverse postoperative outcomes by adjusting other thrombotic or inflammatory biomarkers. Predictive efficacy was defined by area under the curve (AUC) of receiver operating characteristic curve (ROC).Results: A total of 213 patients with ATAAD were finally enrolled. They were categorized as group A (n=160) and group B (n=53) according to postoperative outcomes. Compared with group A, CRP levels of group B were higher (22.40(10.00, 32.51) vs. 11.06(6.21, 22.88), p<0.01)and so were D-dimer levels (12.55(7.74, 30.92) vs 6.21(2.75, 9.45), p<0.01). After controlling for potentially relevant confounding variables, we found admission CRP and D-dimer were independent predictors of adverse postoperative outcomes (odds ratio, 1.163; 95% CI, 1.066 to 1.269; p = 0.001; odds ratio, 1.227; 95% CI, 1.096 to 1.374; p<0.001, respectively). The predictive accuracy of the combination of CRP and D-dimer (AUC：0.849) was superior to that of CRP or D-dimer alone (AUC：0.669，0.763, respectively).Conclusion: CRP and D-dimer on admission are independent predictors of adverse postoperative outcomes in patients with ATAAD, which are easy to get without paying more either for the individual or the medical system. Combination of these two markers will improve the predictive efficacy.

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Association of Lymphocyte to Monocyte Ratio and Risk of In-Hospital Mortality in Patients with Acute Type A Aortic Dissection

Cited by 31 publications

References 27 publications

Relationship of Platelet Counts and Inflammatory Markers to 30-Day Mortality Risk in Patients with Acute Type A Aortic Dissection

Relationship of Platelet Counts and Inflammatory Markers to 30-Day Mortality Risk in Patients with Acute Type A Aortic Dissection

Association Between the Admission Serum Bicarbonate and Short-Term and Long-Term Mortality in Acute Aortic Dissection Patients Admitted to the Intensive Care Unit

Efficacy of CRP In Combination With D-Dimer In Predicting Adverse Postoperative Outcomes of Patients With Acute Stanford Type A Aortic Dissection

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