Association Between Preoperative De Ritis (AST/ALT) Ratio and Oncological Outcomes Following Radical Cystectomy in Patients With Urothelial Bladder Cancer

Ghahari, Mohammadreza; Salari, Abolfazl; Yazdi, Seyed Mahmoud Ghafouri; Nowroozi, Ali; Fotovat, Amirreza; Momeni, Seyed Ali; Nowroozi, Mohammad Reza; Amini, Erfan

doi:10.1016/j.clgc.2021.10.007

Cited by 17 publications

(29 citation statements)

References 21 publications

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“…No significant differences in preexisting comorbidities among the three groups of patients were observed. A significantly higher ISS was observed in patients in the tertile 3 group than in the tertile 2 group (median [IQR, Q3–Q3]: 13 [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ] vs. 13 [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ], respectively; p < 0.001). In addition, a significantly higher ISS was observed in patients in the tertile 2 group than in the tertile 1 group (median [IQR]: 13 [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ] vs. 10 [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ], respectively; p < 0.001).…”

Section: Resultsmentioning

confidence: 99%

“…A significantly higher ISS was observed in patients in the tertile 3 group than in the tertile 2 group (median [IQR, Q3–Q3]: 13 [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ] vs. 13 [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ], respectively; p < 0.001). In addition, a significantly higher ISS was observed in patients in the tertile 2 group than in the tertile 1 group (median [IQR]: 13 [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ] vs. 10 [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ], respectively; p < 0.001). When the injury severity of patients was stratified by an ISS of 16–24 or an ISS ≥ 25, there were no significant differences in patient proportions among these groups; however, significantly more patients in the tertile 1 group had an ISS of 1–15, but fewer had an ISS of 16–24 than those in the tertile 2 group.…”

Section: Resultsmentioning

confidence: 99%

“…The AST/ALT ratio, also called the De Ritis ratio [ 9 ], was first proposed in 1957 to differentiate various causes of liver disease [ 8 , 10 , 11 ]. Furthermore, the De Ritis ratio has been demonstrated to be an independent prognostic predictor for many kinds of malignancies [ 12 , 13 , 14 , 15 ] and non-malignant diseases, such as nonalcoholic fatty liver disease (NAFLD) [ 8 , 16 ], heart diseases [ 17 , 18 , 19 ], acute kidney injury [ 19 , 20 , 21 ], sepsis [ 22 ], and even in patients with COVID-19 [ 23 , 24 , 25 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

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Association between Elevated De Ritis Ratio and Mortality Outcome in Adult Patients with Thoracoabdominal Trauma

Rau

Chou

et al. 2022

Healthcare

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The De Ritis ratio is widely used to differentiate various causes of liver disease and serves as an independent prognostic predictor for different malignancies and non-malignant illnesses. This retrospective study aimed to identify the association between the De Ritis ratio on admission and mortality outcomes in adult thoracoabdominal trauma patients. A total of 2248 hospitalized adult trauma patients with thoracoabdominal injury, defined as an abbreviated injury scale (AIS) score ≥ 1 in the thoracic and abdominal regions, between 1 January 2009, and 31 December 2019, were included. They were categorized into three tertile groups according to the De Ritis ratio. A 1:1 propensity score-matched study group was established to attenuate the confounding effect of patient characteristics on the mortality outcome assessment. The AST levels of the tertile 1, 2, and 3 groups were 115.8 ± 174.9, 115.7 ± 262.0, and 140.5 ± 209.7 U/L, respectively. Patients in the tertile 3 group had a significantly higher level of AST than those in the tertile 1 group (p = 0.032). In addition, patients in the tertile 1 group had a significantly higher level of ALT than those in the tertile 2 and 3 groups (115.9 ± 158.1 U/L vs. 74.5 ± 107.0 U/L and 61.9 ± 86.0 U/L, p < 0.001). The increased De Ritis ratio in trauma patients with thoracoabdominal injuries was mainly attributed to elevated AST levels. The propensity score-matched patient cohorts revealed that the patients in the tertile 3 group presented a 3.89-fold higher risk of mortality than the patients in the tertile 2 group. In contrast, the patients in the tertile 1 group did not have a significantly different mortality rate than those in the tertile 2 group. This study suggests that a De Ritis ratio > 1.64 may be a useful biomarker to identify patients with a higher risk for mortality.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association between Elevated De Ritis Ratio and Mortality Outcome in Adult Patients with Thoracoabdominal Trauma

Rau

Chou

et al. 2022

Healthcare

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“…Because the AST level is associated with other organs affected systemically and ALT level specifically indicates parenchymal liver disease, changes in these two enzymes may be useful for the diagnosis or risk stratification of various illnesses [ 9 ]. Serum ratio of AST/ALT, the so-called “De Ritis ratio (DRR)”, has been reported to be a valuable marker in differentiating varying causes of liver disease [ 9 , 13 , 14 ], surrogating different kinds of malignancies [ 13 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ], and provides valuable information on the risk assessment of patients with heart diseases [ 22 , 23 , 24 ], acute kidney injury [ 25 , 26 , 27 ], sepsis [ 28 ], and even patients with COVID-19 [ 29 , 30 , 31 , 32 ].…”

Section: Introductionmentioning

confidence: 99%

Delta De Ritis Ratio Is Associated with Worse Mortality Outcomes in Adult Trauma Patients with Moderate-to-Severe Traumatic Brain Injuries

et al. 2022

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This study aimed to investigate whether changes in the De Ritis ratio (DRR) can be used to stratify the mortality risk of patients with moderate-to-severe traumatic brain injury (TBI). This retrospective study reviewed data for 1347 adult trauma patients (134 deaths and 1213 survival) with moderate-to-severe TBI between 1 January 2009, and 31 December 2020, from the registered trauma database. The outcomes of the patients allocated into the two study groups were compared based on the best Delta DRR (ΔDRR) cutoff point. The first and second DRR of patients who died were significantly higher than those of patients who survived. Elevation of DRR 72–96 h later was found for patients who died, but not for those who survived; the ΔDRR of the patients who died was significantly higher than that of those who survived (1.4 ± 5.8 vs. −0.1 ± 3.3, p = 0.004). Multivariate logistic regression analysis revealed that ΔDRR was a significant independent risk factor for mortality in these patients. Additionally, a ΔDRR of 0.7 was identified as the cutoff value for mortality stratification of adult trauma patients at high risk of mortality with moderate-to-severe TBI.

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“…Ischemia-reperfusion injury, oxidative stress, and metabolic disorders can increase serum levels of AST [ 4 , 5 , 6 ]. Therefore, DRR has also been proposed to be valuable in the diagnosis and risk stratification of many illnesses other than liver diseases, including cancers other than hepatoma [ 1 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ], acute kidney injury [ 14 , 15 , 16 ], heart diseases [ 17 , 18 , 19 ], sepsis [ 20 ], and coronavirus disease 2019 (COVID-19) [ 21 , 22 , 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

Using Second Measurement of De Ritis Ratio to Improve Mortality Prediction in Adult Trauma Patients in Intensive Care Unit

Rau

Chou

et al. 2022

Diagnostics

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The De Ritis ratio (DRR), the ratio of serum levels of aspartate aminotransferase/alanine aminotransferase, has been reported to be a valuable biomarker in risk stratification for many liver and non-liver diseases. This study aimed to explore whether the inclusion of DRR at the date of intensive care unit (ICU) admission or days after ICU admission improves the predictive performance of various prognosis prediction models. This study reviewed 888 adult trauma patients (74 deaths and 814 survivors) in the trauma registered database between 1 January 2009, and 31 December 2020. Medical information with AST and ALT levels and derived DRR at the date of ICU admission (1st DRR) and 3–7 day after ICU admission (2nd DRR) was retrieved. Logistic regression was used to build new probability models for mortality prediction using additional DRR variables in various mortality prediction models. There was no significant difference in the 1st DRR between the death and survival patients; however, there was a significantly higher 2nd DRR in the death patients than the survival patients. This study showed that the inclusion of the additional DRR variable, measured 3–7 days after ICU admission, significantly increased the prediction performance in all studied prognosis prediction models.

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Association Between Preoperative De Ritis (AST/ALT) Ratio and Oncological Outcomes Following Radical Cystectomy in Patients With Urothelial Bladder Cancer

Cited by 17 publications

References 21 publications

Association between Elevated De Ritis Ratio and Mortality Outcome in Adult Patients with Thoracoabdominal Trauma

Association between Elevated De Ritis Ratio and Mortality Outcome in Adult Patients with Thoracoabdominal Trauma

Delta De Ritis Ratio Is Associated with Worse Mortality Outcomes in Adult Trauma Patients with Moderate-to-Severe Traumatic Brain Injuries

Using Second Measurement of De Ritis Ratio to Improve Mortality Prediction in Adult Trauma Patients in Intensive Care Unit

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