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

BMC Cardiovascular Disorders

Research Article

Guanbiao Liang¹  Yihuan Luo²  Wei Wang²  Yansong Xu²  Cuiqing Huang²  Zheng Liang²  Silei Liang³ 

[1] Cardiothoracic Surgery Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, China;Emergency Surgery Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, China;Trauma Center, The First Affiliated Hospital of Guangxi Medical University, Nanning, China;Medical Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, China;

关键词: Acute aortic dissection;    D-dimer;    D-dimer to lymphocyte;    Count ratio;    In-hospital mortality;   

DOI  :  10.1186/s12872-023-03098-x

 received in 2022-01-05, accepted in 2023-01-26,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundInflammatory factors are well-established indicators for vascular disease, but the D-dimer to lymphocyte count ratio (DLR) is not measured in routine clinical care. Screening of DLR in individuals may identify individuals at in-hopital mortality of acute aortic dissection (AD).MethodsA retrospective analysis of clinical data from 2013 to 2020 was conducted to identify which factors were related to in-hospital mortality risk of AD. Baseline clinical features, cardiovascular risk factors, and laboratory parameters were obtained from the hospital database. The end point was in-hospital mortality. Forward conditional logistic regression was performed to identify independent risk factors for AA in-hospital death. The cutoff value of the DLR should be ideally calculated by receiver operating characteristic (ROC) analysis.ResultsThe in-hospital mortality rate was 15% (48 of 320 patients). Patients with in-hospital mortality had a higher admission mean DLR level than the alive group (1740 vs. 1010, P < .05). The cutoff point of DLR was 907. The in-hospital mortality rate in the high-level DLR group was significantly higher than that in the low-level DLR group (P < .05). Univariate analysis showed that 8 of 38 factors were associated with in-hospital mortality (P < .05), including admission WBC, neutrophils, lymphocytes, neutrophils/lymphocytes (NLR), prothrombin time (PT), heart rate (HR), D-dimer, and DLR. In multivariate analysis, DLR (odds ratio [OR] 2.127, 95% CI 1.034–4.373, P = 0.040), HR (odds ratio [OR] 1.016, 95% CI 1.002–1.030, P = 0.029) and PT (odds ratio [OR] 1.231, 95% CI 1.018–1.189, P = 0.032) were determined to be independent predictors of in-hospital mortality (P < .05).ConclusionCompared with the common clinical parameters PT and HR, serum DLR level on admission is an uncommon but independent parameter that can be used to assess in-hospital mortality in patients with acute AD.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 1

12936_2023_4483_Article_IEq20.gif

Fig. 1

Fig. 7

Fig. 2

Fig. 5