Key result
Elevated preoperative D-dimer is linked to ~47% higher in-hospital mortality in type A aortic dissection.
Why the study?
The predictive value of preoperative inflammatory and coagulation biomarkers for postoperative in-hospital deaths in patients with type A acute aortic dissection was unclear.
Do preoperative inflammatory and coagulation biomarkers predict postoperative in-hospital deaths in patients with type A acute aortic dissection?
Cohort (n=206)
No
Do preoperative inflammatory and coagulation biomarkers predict postoperative in-hospital deaths in patients with type A acute aortic dissection?
Preoperative D-dimer and WBC levels independently predict in-hospital mortality in patients undergoing surgery for type A acute aortic dissection.
Background: The aim of this study was to analyze the predictive value of biomarkers related to preoperative inflammatory and coagulation in the prognosis of patients with type A acute aortic dissection (AAD). Methods: A total of 206 patients with type A AAD who had received surgical treatment were enrolled. Patients were divided into two groups according to whether they died during hospitalization. Peripheral blood samples were collected before anesthesia induction. Preoperative levels of D-dimer, fibrinogen (FIB), platelet (PLT), white blood cells (WBC) and neutrophil (NEU) between the two groups were compared. Univariate and multivariate 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 D-dimer, FIB, PLT, WBC, NEU and CRP in the prognosis of the patients. Results: Univariate 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 multivariate logistic regression analysis indicated that higher preoperative D-dimer and WBC levels were independent risk factors for in-hospital deaths of patients with type A AAD. ROC curve analysis indicated that FIB+PLT combination is provided with the highest predictive value for in-hospital deaths.Conclusion: Both preoperative D-dimer and WBC in patients with type A AAD may be used as independent risk factors for the prognosis of such patients. Combined use of FIB and PLT may improve the accuracy and accessibility of clinical prognostic assessment.
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Li et al. (2021) conducted a cohort in Type A acute aortic dissection (n=206). Elevated preoperative D-dimer vs. Lower D-dimer levels was evaluated on All-cause in-hospital mortality (OR 1.471, 95% CI 1.075-2.014, p=0.016). Elevated preoperative D-dimer was an independent risk factor for in-hospital mortality in patients with type A acute aortic dissection, with levels >10.3 mg/L associated with a 24.3% mortality rate compared to 7.6% for lower levels.
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