Prognostic value of serum albumin for patients with acute aortic dissection

Gao, Yunkai; Li, Dongze; Cao, Yu; Zhu, Xingyu; Zeng, Zhi; Tang, Li

doi:10.1097/md.0000000000014486

Cited by 22 publications

(27 citation statements)

References 33 publications

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“…In a previous study a lower serum albumin level was independently associated with increased in-hospital mortality in both type A and B acute AD. 29 Different from that study, in current study we included a more specific patient population as only ATAAD patients who treated surgically. In addition, in that study as a single inflammation marker serum albumin's prognostic significance was investigated, while in our study the PNI, which integrate two inflammation markers as a combination of serum albumin and lymphocyte, was evaluated regarding in-hospital mortality.…”

Section: Discussionmentioning

confidence: 99%

Prognostic nutritional index predicts in-hospital mortality in patients with acute Stanford type A aortic dissection

et al. 2020

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Background: Acute Stanford type A aortic dissection (ATAAD) is a life-threatening medical emergency. The aim of this study was to investigate the clinical significance of the prognostic nutritional index (PNI) as a novel inflammatory marker for ATAAD patients undergoing surgical repair. Methods: We retrospectively examined the medical records of 151 ATAAD patients who treated surgically. Patients were divided into two groups (survival and death) and these groups were compared with respect to clinical and laboratory parameters. The PNI was calculated as 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm3). Logistic regression analyses were performed to identify the risk factors of in-hospital mortality. Results: The mean age of the study cohort was 61 ± 12 years, 99 (65.6%) were males, and 35 (23.2%) patients died during the hospital stay. The PNI levels were significantly lower in death group compared with survival group (32.80 ± 4.90 vs. 37.94 ± 5.42, p < 0.001). Multivariate analysis showed that the PNI (OR: 0.795, p = 0.005), age (odds ratio [OR]: 1.085, p = 0.034), operating time (OR: 1.660, p = 0.042), and D-dimer (OR: 1.002, p = 0.001) independently predicted in-hospital mortality. The calculated cutoff value of the PNI was 33.01. Conclusion: Lower PNI values are independently associated with in-hospital mortality in ATAAD. The PNI may be a useful tool for predicting the early mortality of ATAAD patients after surgical repair.

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Section: Discussionmentioning

confidence: 99%

Prognostic nutritional index predicts in-hospital mortality in patients with acute Stanford type A aortic dissection

et al. 2020

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“…[ 16 ] Results of previous studies have found that the thrombo-inflammatory status reflects the severity of AMI and that a thrombo-inflammatory prognostic system is more predictive than a single inflammatory or thrombotic marker. [ 5 , 6 , 17 ] SA is a negatively charged plasma protein with antioxidant functions that can signal inflammatory regulatory changes in cells that is dependent on their redox state. [ 18 – 20 ] Results of previous studies revealed that decreased synthesis and increased catabolism of SA were associated with inflammation and that SA inhibited platelet activation and aggregation and was a mediator of platelet-induced AMI [ 21 , 22 ] and can predict adverse outcomes of patients with AMI.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of serum albumin-to-creatinine ratio in patients with acute myocardial infarction

Liu

Zhang

et al. 2020

Medicine

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The long-term association between serum albumin-to-creatinine ratio (sACR) and poor patient outcomes in acute myocardial infarction (AMI) remains unclear. This study aimed to determine whether sACR was a predictor of poor long-term survival in patients with AMI. This was a study of patients with AMI in the emergency department (ED) from the retrospective multicenter study for early evaluation of acute chest pain (REACP) study. The patients were categorized into tertiles (T1, T2, and T3) based on the admission sACR (0.445 and 0.584 g/μmol). Baseline sACR at admission to the ED was predictive of adverse outcomes. The primary outcome was all-cause mortality within the follow-up period. Cox proportional hazards models were performed to investigate the association between sACR and all-cause mortality in patients with AMI. A total of 2250 patients with AMI were enrolled, of whom 229 (10.2%) died within the median follow-up period of 10.7 (7.2–14.6) months. Patients with a lower sACR had higher all-cause mortality and adverse outcomes rates than patients with a higher sACR. Kaplan–Meier survival analysis showed that patients with a higher sACR had a higher cumulative survival rate ( P < .001). Cox regression analysis showed that a decreased sACR was an independent predictor of all-cause mortality [T2 vs T1: hazard ratio (HR); 0.550, 95% confidence interval (95% CI), 0.348–0.867; P = .010 and T3 vs T1: HR, 0.305; 95% CI, 0.165–0.561; P < .001] and cardiac mortality (T2 vs T1: HR, 0.536; 95% CI, 0.332–0.866; P = .011 and T3 vs T1: HR, 0.309; 95% CI, 0.164–0.582, P < .001). The sACR at admission to ED was independently associated with adverse outcomes, indicating that baseline sACR was a useful biomarker to identify high-risk patients with AMI at an early phase in ED.

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“…According with previous studies [ 4 , 7 , 16 ], patients with a maximum aortic diameter ≥ 5.5 cm, renal dysfunction or albumin amount ≤ 30 g/L were more likely to experience in-hospital mortality or organ malperfusion. D-dimer level ≥ 5.44 μg/mL was the last identified risk factor.…”

Section: Discussionmentioning

confidence: 89%

Prognostic dynamic nomogram integrated with metabolic acidosis for in-hospital mortality and organ malperfusion in acute type B aortic dissection patients undergoing thoracic endovascular aortic repair

Liu

et al. 2021

BMC Cardiovasc Disord

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Background Organ malperfusion is a lethal complication in acute type B aortic dissection (ATBAD). The aim of present study is to develop a nomogram integrated with metabolic acidosis to predict in-hospital mortality and organ malperfusion in patients with ATBAD undergoing thoracic endovascular aortic repair (TEVAR). Methods The nomogram was derived from a retrospectively study of 286 ATBAD patients who underwent TEVAR from 2010 to 2017 at a single medical center. Model performance was evaluated from discrimination and calibration capacities, as well as clinical effectiveness. The results were validated using a prospective study on 77 patients from 2018 to 2019 at the same center. Results In the multivariate analysis of the derivation cohort, the independent predictors of in-hospital mortality and organ malperfusion identified were base excess, maximum aortic diameter ≥ 5.5 cm, renal dysfunction, D-dimer level ≥ 5.44 μg/mL and albumin amount ≤ 30 g/L. The penalized model was internally validated by bootstrapping and showed excellent discriminatory (bias-corrected c-statistic, 0.85) and calibration capacities (Hosmer–Lemeshow P value, 0.471; Brier Score, 0.072; Calibration intercept, − 0.02; Slope, 0.98). After being applied to the external validation cohort, the model yielded a c-statistic of 0.86 and Brier Score of 0.097. The model had high negative predictive values (0.93–0.94) and moderate positive predictive values (0.60–0.71) for in-hospital mortality and organ malperfusion in both cohorts. Conclusions A predictive nomogram combined with base excess has been established that can be used to identify high risk ATBAD patients of developing in-hospital mortality or organ malperfusion when undergoing TEVAR.

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Prognostic value of serum albumin for patients with acute aortic dissection

Cited by 22 publications

References 33 publications

Prognostic nutritional index predicts in-hospital mortality in patients with acute Stanford type A aortic dissection

Prognostic nutritional index predicts in-hospital mortality in patients with acute Stanford type A aortic dissection

Prognostic value of serum albumin-to-creatinine ratio in patients with acute myocardial infarction

Prognostic dynamic nomogram integrated with metabolic acidosis for in-hospital mortality and organ malperfusion in acute type B aortic dissection patients undergoing thoracic endovascular aortic repair

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