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- Title
U-shaped relationship between platelet-lymphocyte ratio and postoperative in-hospital mortality in patients with type A acute aortic dissection.
- Authors
Xie, Xi; Fu, Xiangjie; Zhang, Yawen; Huang, Wanting; Huang, Lingjin; Deng, Ying; Yan, Danyang; Yao, Run; Li, Ning
- Abstract
<bold>Background: </bold>The platelet-lymphocyte ratio (PLR), a novel inflammatory marker, is generally associated with increased in-hospital mortality risk. We aimed to investigate the association between PLR and postoperative in-hospital mortality risk in patients with type A acute aortic dissection (AAAD).<bold>Methods: </bold>Patients (n = 270) who underwent emergency surgery for AAAD at Xiangya Hospital of Central South University between January 2014 and May 2019 were divided into three PLR-based tertiles. We used multiple regression analyses to evaluate the independent effect of PLR on in-hospital mortality, and smooth curve fitting and a segmented regression model with adjustment of confounding factors to analyze the threshold effect between PLR and in-hospital mortality risk.<bold>Results: </bold>The overall postoperative in-hospital mortality was 13.33%. After adjusting for confounders, in-hospital mortality risk in the medium PLR tertile was the lowest (Odds ratio [OR] = 0.20, 95% confidence interval [CI] = 0.06-0.66). We observed a U-shaped relationship between PLR and in-hospital mortality risk after smoothing spline fitting was applied. When PLR < 108, the in-hospital mortality risk increased by 10% per unit decrease in PLR (OR = 0.90, P = 0.001). When the PLR was between 108 and 188, the mortality risk was the lowest (OR = 1.02, P = 0.288). When PLR > 188, the in-hospital mortality risk increased by 6% per unit increase in PLR (OR = 1.06, P = 0.045).<bold>Conclusions: </bold>There was a U-shaped relationship between PLR and in-hospital mortality in patients with AAAD, with an optimal PLR range for the lowest in-hospital mortality risk of 108-188. PLR may be a useful preoperative prognostic tool for predicting in-hospital mortality risk in patients with AAAD and can ensure risk stratification and early treatment initiation.
- Subjects
PLATELET lymphocyte ratio; HOSPITAL mortality; AORTIC dissection; PROGNOSTIC tests; CURVE fitting; AORTIC aneurysm diagnosis; CARDIOVASCULAR surgery; DISSECTING aneurysms; RESEARCH; PREDICTIVE tests; TIME; RESEARCH methodology; AORTIC aneurysms; RETROSPECTIVE studies; EVALUATION research; TREATMENT effectiveness; RISK assessment; COMPARATIVE studies; PLATELET count; HOSPITAL care; RESEARCH funding; ACUTE diseases; LYMPHOCYTE count
- Publication
BMC Cardiovascular Disorders, 2021, Vol 21, Issue 1, p1
- ISSN
1471-2261
- Publication type
journal article
- DOI
10.1186/s12872-021-02391-x