Key result
Higher preoperative D-dimer (OR 1.471) and white blood cell levels (OR 1.645) were independent risk factors for postoperative in-hospital mortality in patients with type A acute aortic dissection.
Why the study?
The study was conducted to analyze the role of blood biomarkers of preoperative inflammation and coagulation in predicting postoperative in-hospital mortality in patients with type A acute aortic dissection.
Do preoperative inflammatory and coagulation biomarkers predict postoperative in-hospital mortality in patients with type A acute aortic dissection?
Observational (n=206)
Blinded data analysis
No
Do preoperative inflammatory and coagulation biomarkers predict postoperative in-hospital mortality in patients with type A acute aortic dissection?
Odds Ratio: 1.471 (95% CI 1.075–2.014)
p-value: p=0.016
Preoperative D-dimer and WBC may aid mortality risk stratification in type A AAD; leaves open prospective validation before clinical adoption.
The aim of this study was to analyze the role of blood biomarkers regarding preoperative inflammation and coagulation in predicting the postoperative in-hospital mortality of patients with type A acute aortic dissection (AAD). A total of 206 patients with type A AAD who had received surgical treatment were enrolled in this study. Patients were divided into two groups: the death group (28 patients who died during hospitalization) and the survival group (178 patients). Peripheral blood samples were collected before anesthesia induction. Preoperative levels of D-dimer, fibrinogen (FIB), platelet (PLT), white blood cells (WBC) and neutrophil (NEU) were compared between the two groups. Univariable and multivariable logistic regression analysis were utilized to identify the independent risk factors for postoperative in-hospital deaths of patients with type A AAD. Receiver operating characteristic (ROC) curve were used to analyze the predictive value of these indices in the postoperative in-hospital mortality of the patients. Univariable logistic regression analysis showed that the P values of the five parameters including D-dimer, FIB, PLT, WBC and NEU were all less than 0.1, which may be risk factors for postoperative in-hospital deaths of patients with type A AAD. Further multivariable logistic regression analysis indicated that higher preoperative D-dimer and WBC levels were independent risk factors for postoperative in-hospital mortality of patients with type A AAD. ROC curve analysis indicated that application of combining FIB and PLT could improve accuracy in prediction of postoperative in-hospital mortality in patients with type A AAD. Both preoperative D-dimer and WBC in patients with type A AAD may be used as independent risk factors for the postoperative in-hospital mortality of such patients. The combination of FIB and PLT may improve the accuracy of clinical prognostic assessment.
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Li et al. (2021) conducted an observational in Type A acute aortic dissection (n=206). Preoperative D-dimer and WBC levels vs. Lower biomarker levels was evaluated on Postoperative in-hospital mortality (OR 1.471, 95% CI 1.075-2.014, p=0.016). Higher preoperative D-dimer (OR 1.471) and white blood cell levels (OR 1.645) were independent risk factors for postoperative in-hospital mortality in patients with type A acute aortic dissection.
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