Early-term prognosis in patients with acute aortic dissection: calm before the storm

Abstract

Dear Editor, We have read the article by Dönmez et al. 1 , entitled "Evaluation of descriptive performances of platelet indices, neutrophil/ lymphocyte ratio, and platelet/lymphocyte ratio in aortic dissections" with great interest. First of all, we congratulate the authors for their valuable contribution to the literature. However, we would like to discuss some points about acute aortic dissection and its early-term mortality.Acute aortic dissections are important cardiovascular emergencies with high perioperative mortality and morbidity which require urgent interventions 2 . Various parameters obtained from routine blood values have been investigated in the literature to predict early clinical outcomes. These are usually neutrophil, lymphocyte, C-reactive protein, and platelet-related parameters 3,4 . However, while investigating these parameters as clinical predictors, we think that important determinants of mortality should be included in the analysis. The most important of these determinants are the types of performed intervention according to dissection types (surgery, endovascular intervention, medical treatment, etc.), the perfusion methods used in the surgery, the amount of blood products used, the preoperative left ventricular ejection fraction, the presence of low-cardiac output syndrome, and the time between surgery and the first symptom 5 . In addition, in the case of type 2 dissection, only the ascending aorta limited dissection status may also have an impact on mortality 6 .However, the rate of DeBakey Type 1 dissection in the 30-day survival group in the study was approximately twice that of the 30-day mortality group. The DeBakey Type 2 dissection rate was more than twice in the 30-day mortality group than in the 30-day survival group. This information