Increased Neutrophil to Lymphocyte Ratio is Associated with In-Hospital Mortality in Patients with Aortic Dissection

Onuk, Tolga; Güngör, Barış; Karataş, Baran; İpek, Göktürk; Akyüz, Şükrü; Özcan, Kazım Serhan; Ugur, S.Y.; Onuk, Burak Emre; Yelgeç, Nizamettin Selçuk; Kaşıkçıoğlu, Hülya; Çam, Neşe

doi:10.7754/clin.lab.2015.150216

Cited by 18 publications

(19 citation statements)

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“…It has been found that leukocytes are associated with the adverse prognosis in glioma 4 , coronary artery disease 5 , abdominal aortic aneurysms 6 . Pozzilli 7 and Yoshimoto 8 reported that higher leukocyte counts in peripheral blood were acute systemic inflammatory response following subarachnoid hemorrhage, and the number of leukocytes reflected the degree of brain tissue damage and predicted further secondary brain injury.…”

Section: Introductionmentioning

confidence: 99%

Higher leukocyte count predicts 3-month poor outcome of ruptured cerebral aneurysms

Yao¹,

Chen²,

Xie³

et al. 2018

Sci Rep

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It is not fully established whether leukocyte can predict the poor outcome for ruptured cerebral aneurysms (CA) or not. Here, we retrospectively analyzed the clinical data of 428 patients with ruptured CA between 2010 and 2015. Patients’ demographic data, including gender, age, history of smoking, alcohol, hypertension, diabetes and hypercholesterolemia, Hunt-Hess and Fisher grade, occurrence of hydrocephalus, aneurysm location, time to surgery, delayed ischemic neurological deficit (DIND) and peak leukocyte of blood test from day 1 to 3 after aneurysmal rupture were recorded and analyzed. In the multivariable analysis model, gender, Fisher grade, time to surgery and hydrocephalus were not relevant to poor outcome. However, Hunt-Hess grade, DIND and preoperative leukocyte count (>13.84 × 109/L) were significantly associated with adverse outcome. The respective increased risks were 5.2- (OR 5.24, 95% CI 1.67–16.50, p = 0.005), 6.2-(OR 6.24, 95% CI 3.55–10.99, p < 0.001) and 10.9-fold (OR 10.93, 95% CI 5.98–19.97, p < 0.001). The study revealed that Hunt-Hess grade, DIND and preoperative leukocyte count (>13.84 × 109/L) were independent risk factors for poor outcome of ruptured CA at 3 months. Higher leukocyte count is a convenient and useful marker to predict 3-month poor outcome for ruptured CA.

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Section: Introductionmentioning

confidence: 99%

Higher leukocyte count predicts 3-month poor outcome of ruptured cerebral aneurysms

Yao¹,

Chen²,

Xie³

et al. 2018

Sci Rep

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“…In patients with ATAAD, hemodynamic instability can occur as a result of cardiac tamponade or aortic insufficiency, and emergency aortic repair under cardiopulmonary bypass induces a strong perioperative inflammatory response, making investigation of the early inflammatory response more complicated. Nevertheless, there is evidence that systemic inflammation characterized by elevation of the white blood cell (WBC) count [12][13][14] or an increased neutrophil/lymphocyte ratio [13,15,16] influences outcomes in patients with ATAAD. Although biomarkers of disordered coagulation and fibrinolysis D-dimer and fibrin degradation products have been well studied in relation to acute aortic dissection [17][18][19], WBC count elevation and its etiology in cases of acute aortic dissection have not been fully elucidated, and the relation between WBC elevation and dissection morphology is poorly understood.…”

Section: Introductionmentioning

confidence: 99%

Factors related to white blood cell elevation in acute type A aortic dissection

et al. 2020

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Aortic dissection may induce a systemic inflammatory reaction. The etiological backgrounds for elevation of the white blood cell count remain to be clarified. In 466 patients with acute type A aortic dissection treated surgically within 48 hours of symptom onset, the etiologic background of an elevated admission white blood cell count and the effect of such elevation on outcomes were assessed retrospectively. Patients' white blood cell count differed significantly in relation to the extent of dissection, with a median (25th, 75th percentile) white blood cell count of 10.4 (8.1, 13.9) x 10 3 /μL for dissection confined to the ascending aorta, 10.5 (8.2,13.) 10 3 /μL for dissection extending to the aortic arch/descending aorta, 11.1 (8.2, 13.7) x 10 3 /μL for extension to the abdominal aorta, and 13.3 (9.8, 15.9) x 10 3 /μL for extension to the iliac artery (p<0.001). With 11.0 x 10 3/ μL used as the cutoff value for white blood cell count elevation, multivariable analysis showed current smoking (p<0.001; odds ratio, 2.79), dissection extending to the iliac artery (p = 0.006; odds ratio, 1.79), age (p = 0.007, odds ratio, 0.98), and no coronary ischemia (p = 0.027, odds ratio, 2.22) to be factors related to the elevated white blood cell count. Mean age differed significantly between patients with and without an elevated white blood cell count (62.3 vs. 68.3 years, p <0.001). Although inhospital mortality was similar (7.5% vs.10.9%, p = 0.19), 5-year survival was lower in patients without an elevated count (85.7% vs. 78.6%, p = 0.019), reflecting their more advanced age. In conclusion, our data suggest that dissection morphology and patient age influence the acute phase systemic inflammatory response associated with an elevated white blood cell count in patients with ATAAD. A better understanding of this relation may help optimize diagnosis and perioperative care.

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“…1. After reviewing the full-text articles, the remaining 14 observational studies were included in current meta-analysis [13][14][15][16][17][18][19][20][21][22][23][24][25][26].…”

Section: General Characteristic Of Studies Included In the Metaanalysismentioning

confidence: 99%

“…Recently, the relationship between NLR and aortic disease has been investigated by several studies [11,12]. Authors focus on the NLR level in aortic aneurysm and aortic dissection patients, and the predictive value of high NLR in mortality and other clinical outcomes [13][14][15][16][17][18][19][20][21][22][23][24][25][26]. Therefore, the current meta-analysis was performed to clarify the relationship between NLR and aortic disease.…”

Section: Introductionmentioning

confidence: 99%

Prognostic role of neutrophil-to-lymphocyte ratio in aortic disease: a meta-analysis of observational studies

Fang

Qiu

et al. 2020

J Cardiothorac Surg

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Objective: Recent studies have reported that neutrophil-to-lymphocyte ratio (NLR) is associated with cardiovascular disease. The aim of the present study was to investigate the prognostic value of NLR in aortic disease. Methods: We systematically searched electronic databases (Cochrane, PubMed, Elsevier, Medline, and Embase) from their inception to March 2020. Observational studies that evaluated the relationship between NLR and aortic disease were eligible for critical appraisal. Data were extracted from applicable articles, risk ratio (RR), weighted mean differences (MD) and 95% confidence intervals (CI) were calculated by RevMan 5.3, and statistical heterogeneity was assessed by the I 2 statistic. Results: Fourteen studies enrolling 4066 individuals were included in the meta-analysis. Compared with the control group, NLR was significantly higher in the aortic disease group (MD 3.44, 95%CI: 0.81-6.07, P = 0.01, I 2 = 99%). The NLR was also significantly higher in non-survivors with aortic disease, compared to the survivors (MD 4.62, 95%CI: 2.75-6.50, P < 0.00001, I 2 = 60%). Compared with the aortic disease patients with a low NLR, mortality was significantly higher in those with a high NLR (RR 2.63, 95%CI: 1.79-3.86, P < 0.00001, I 2 = 67%). Conclusion: Based on current evidence, an elevated NLR was associated with aortic disease and in-hospital mortality. Raised NLR also demonstrated a significantly increased the risk of mortality after surgical repair in aortic disease patients. NLR may be a good prognostic biomarker in aortic disease and deserve further research in this area.

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Increased Neutrophil to Lymphocyte Ratio is Associated with In-Hospital Mortality in Patients with Aortic Dissection

Cited by 18 publications

References 0 publications

Higher leukocyte count predicts 3-month poor outcome of ruptured cerebral aneurysms

Higher leukocyte count predicts 3-month poor outcome of ruptured cerebral aneurysms

Factors related to white blood cell elevation in acute type A aortic dissection

Prognostic role of neutrophil-to-lymphocyte ratio in aortic disease: a meta-analysis of observational studies

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