Objective: The systemic Immune-inflammation Index (SII) is a biomarker developed reflecting the effectiveness of the inflammatory response. This index has been demonstrated as a predictor of adverse outcomes in various disease states. Our study aimed to determine the predictive value of SII for mortality and morbidity in patients undergoing surgery for acute type A aortic dissection (TAAD) at our institution. Materials and Methods: We investigated 300 patients who underwent surgery for TAAD at our clinic between July 2014 and February 2025. We used receiver operating characteristic curve analysis, the optimal cutoff value for SII to predict in-hospital mortality was determined. Patients were subsequently divided into two groups based on this value: 162 patients (54%) in Group A (SII <1334,9 × 10 9 /L) and 138 patients (46%) in Group B (SII ≥1334.9 × 10 9 /L). Cox regression analysis was performed to identify factors affecting in-hospital mortality. Kaplan–Meier curves were generated to evaluate the event-free survival regarding in-hospital mortality. Results: Postoperative in-hospital mortality occurred in 74 patients (24,7%). Group B exhibited significantly higher mortality ( P = 0,016). The total hospital length of stay was significantly longer in Group B ( P = 0.047). Multivariate cox regression analysis identified cardiopulmonary bypass duration ( P ≤ 0.001), concomitant CABG ( P = 0.015), postoperative bowel ischemia ( P = 0.044), and SII ≥1334.9 ( P = 0.046) as independent predictors of in-hospital mortality. After discharge, no significant differences between groups were observed regarding reintervention or late mortality. Conclusion: Despite the absence of a demonstrable mid-term effect, we suggest that preoperative SII has potential as a biomarker for predicting the clinical outcomes in patients undergoing surgery for TAAD.
Kaplan et al. (Tue,) studied this question.
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