Prognostic Impact of Systemic Coagulation-Inflammation Index in Acute Type A Aortic Dissection Surgery

Liu, Hong; Qian, Sichong; Shao, Yongfeng; Li, Haiyang; Zhang, Hongjia

doi:10.1016/j.jacasi.2022.06.007

Cited by 16 publications

(18 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Liu et al reported that patients with acute type A aortic dissection (ATAAD) usually had severe inflammatory reactions, which resulted in poor short-term outcomes (25). Thourani et al reported that emergent status on mitral valve replacement surgery and coronary artery bypass grafting (CABG) significantly increased morbidity and mortality (26).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The neutrophil elastase inhibitor, sivelestat, attenuates acute lung injury in patients with cardiopulmonary bypass

et al. 2023

View full text Add to dashboard Cite

BackgroundThe sivelestat is a neutrophil elastase inhibitor thought to have an effect against acute lung injury (ALI) in patients after scheduled cardiac surgery. However, the beneficial effect of sivelestat in patients undergoing emergent cardiovascular surgery remains unclear. We aim to evaluate the effect of sivelestat on pulmonary protection in patients with ALI after emergent cardiovascular surgery.MethodsFirstly, a case-control study in 665 patients undergoing emergent cardiovascular surgery from January 1st, 2020 to October 26th, 2022 was performed. 52 patients who received sivelestat (0.2mg/kg/h for 3 days) and 613 age- and sex-matched controls. Secondly, a propensity-score matched cohort (sivelestat vs control: 50 vs 50) was performed in these 665 patients. The primary outcome was a composite of adverse outcomes, including 30-day mortality, ECMO, continuous renal replacement therapy (CRRT) and IABP, etc. The secondary outcome included pneumonia, ventricular arrhythmias and mechanical ventilation time, etc.ResultsIn propensity-matched patients, the 30-day mortality (16% vs 24%, P=0.32), stroke (2% vs 8%, P=0.17), ECMO(6% vs 10%, P=0.46), IABP(4% vs 8%, P=0.40) and CRRT(8% vs 20%, P=0.08) had no differences between sivelestat and control group; sivelestat could significantly decrease pneumonia (40% vs 62%, P=0.03), mechanical ventilation time (median: 96hours, IQR:72-120hours vs median:148hours, IQR:110-186hours, P<0.01), bilateral pulmonary infiltrates (P<0.01), oxygen index (P<0.01), interleukin-6(P=0.02), procalcitonin(P<0.01) and C-reactive protein(P<0.01).ConclusionAdministration of sivelestat might improve postoperative outcomes in patients with ALI after emergent cardiovascular surgery. Our results show that sivelestat may be considered to protect pulmonary function against inflammatory injury by CPB.Registrationhttp://www.chictr.org.cn/showproj.aspx?proj=166643, identifier ChiCTR2200059102.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Liu et al. reported that patients with acute type A aortic dissection (ATAAD) usually had severe inflammatory reactions, which resulted in poor short-term outcomes ( 25 ). Thourani et al.…”

Section: Discussionmentioning

confidence: 99%

The neutrophil elastase inhibitor, sivelestat, attenuates acute lung injury in patients with cardiopulmonary bypass

et al. 2023

View full text Add to dashboard Cite

show abstract

“…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: 97%

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

Matniyaz

Luo

Jiang

et al. 2023

Preprint

View full text Add to dashboard Cite

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.

show abstract

“…In this issue of JACC: Asia , Liu et al 6 reported the usefulness of a novel hematological parameter, the systemic coagulation-inflammation index (SCI), for risk stratification in patients with ATAAD. Patients with ATAAD who underwent open surgical repair between January 2016 and December 2020 at 12 Chinese cardiovascular centers were retrospectively analyzed.…”

mentioning

confidence: 99%

“…IRAD developed a multivariate model for predicting in-hospital mortality (C-index: 0.787), including time from the initial hospital admission to surgery, age, presenting with hypotension (shock), prior cardiac surgery, preoperative malperfusion, and body mass index. 3 The patients included in the study by Liu et al 6 were younger, had lower body mass indexes, had lower rates of hypotension (shock) or cardiac tamponade, and had no mesenteric malperfusion, resulting in better short-term outcomes than those from IRAD. Moreover, a watchful waiting strategy with medical management and timely surgical intervention may be a reasonable option for stable patients with retrograde ATAAD.…”

mentioning

confidence: 99%

Toward an Easily Obtainable Novel Biomarker for Type A Dissection?

Kim

2022

JACC: Asia

View full text Add to dashboard Cite

Prognostic Impact of Systemic Coagulation-Inflammation Index in Acute Type A Aortic Dissection Surgery

Cited by 16 publications

References 39 publications

The neutrophil elastase inhibitor, sivelestat, attenuates acute lung injury in patients with cardiopulmonary bypass

The neutrophil elastase inhibitor, sivelestat, attenuates acute lung injury in patients with cardiopulmonary bypass

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

Toward an Easily Obtainable Novel Biomarker for Type A Dissection?

Contact Info

Product

Resources

About