Preoperative Uric Acid-to-albumin Ratio as a New Indicator for Predicting Long-term Prognosis in Patients With Acute Type a Aortic Dissection

Objectives— We aimed to analyze the ability of the preoperative uric acid-to-albumin ratio (UAR) to predict the postoperative long-term mortality of patients with type A AAD.Methods —A total of 289 patients with type A AAD who were enrolled in this study. First, all patients were divided into two groups: UAR < 9.875 and UAR ≥ 9.875. Furthermore, according to whether death occurred after one year after surgery, the patients were divided into the non-survival and survival groups. Univariable and multivariable COX regression analyses were conducted to identify the independent risk factors for long-term death in patients with type A AAD. Receiver operating characteristic (ROC) curves were constructed to assess the values of these indices in predicting postoperative mortality. Results— Age, hypertension, albumin content, UAR, and D-dimer content were found to be independent risk factors for mortality. The area under the ROC curve (AUC) of UAR was 0.618(HR 1.904, 95% CI, 1.097 to 3.305; P< 0.05), the combination of UAR, age and D-dimer was best for predicting deaths,the area under the AUC of them was 0.751 [HR 1.904,95% CI,0.681 to 0.821; P< 0.05)].Conclusions—In patients with type A AAD, UAR may considered as a new independent risk factor for long-term mortality. a combination of UAR, age, and D-dimer content was a best predictor of deaths.