Clinical features and risk factors of postoperative in-hospital mortality following surgical repair of Stanford type A acute aortic dissection

Chen, Ke; Wu, Hao; Xi, Min; Shi, Wei; Huang, Qihong; Lü, Gongxuan

doi:10.1186/s12872-021-02107-1

Cited by 11 publications

(9 citation statements)

References 30 publications

(34 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The survival profile of Stanford type A AD patients is unfavorable 7,8,29,30 . Hence, identifying novel biomarkers to estimate the mortality risk and perform early intervention is still necessary.…”

Section: Discussionmentioning

confidence: 99%

“…Subsequently, it was observed that only Th17 cells were positively related to CRP and Ddimer in Stanford type A AD patients, which could be explained as that: (a) Th17 cells upregulated various pro-inflammatory cytokines (such as interleukin (IL)-17, IL-21, and granulocyte macrophagecolony stimulating factor (GM-CSF)) to promote the neutrophil The survival profile of Stanford type A AD patients is unfavorable. 7,8,29,30 Hence, identifying novel biomarkers to estimate the mortality risk and perform early intervention is still necessary. Th17 cells are previously observed to positively correlate with the 3-year mortality rate in Stanford type B AD patients, while its clinical value in Stanford type A AD patients remains exclusive.…”

Section: Crp and D-dimer Are Two Well-established Biomarkers In Acutementioning

confidence: 99%

“…Around 70% of AD patients are Stanford type A AD, which usually requires emergency surgical repair due to the high risk of developing cardiac tamponade or malperfusion syndromes, while medications are commonly applied for the management of Stanford type B AD 5,6 . Despite the advances in surgical techniques and perioperative management, the in‐hospital mortality rate of Stanford type A AD patients remains high 7‐9 . Recently, some prognostic factors have been identified to predict the in‐hospital survival of Stanford type A AD patients, 10,11 while discovering more potential AD biomarkers is still necessary and remains a critical issue for clinicians.…”

Section: Introductionmentioning

confidence: 99%

“…5,6 Despite the advances in surgical techniques and perioperative management, the in-hospital mortality rate of Stanford type A AD patients remains high. [7][8][9] Recently, some prognostic factors have been identified to predict the in-hospital survival of Stanford type A AD patients, 10,11 while discovering more potential AD biomarkers is still necessary and remains a critical issue for clinicians.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Th1, Th2, and Th17 cells are dysregulated, but only Th17 cells relate to C‐reactive protein, D‐dimer, and mortality risk in Stanford type A aortic dissection patients

Song

Deng

Shen

et al. 2022

Clinical Laboratory Analysis

View full text Add to dashboard Cite

Background: T helper (Th) cells are closely involved in vascular inflammation, endothelial dysfunction, and atherogenesis, which are the hallmarks of aortic dissection (AD). This study aimed to evaluate the clinical value of Th1, Th2, and Th17 cell measurements in Stanford type A AD patients. Methods: Stanford type A AD patients (N=80) and non-AD patients with chest pain (N = 40) were recruited. Then, Th1, Th2, and Th17 cells in peripheral blood CD4 + T cells from all participants were detected by flow cytometry. The 30-day mortality of Stanford type A AD patients was recorded.Results: Th1 and Th17 cells were higher, while Th2 cells were lower in Stanford type A AD patients compared with non-AD patients (all p < 0.001). Meanwhile, Th1 cells (area under curve (AUC): 0.734, 95% confidence interval (CI): 0.640-0.828), Th2 cells (AUC: 0.841, 95% CI: 0.756-0.925), and Th17 cells (AUC: 0.898, 95% CI: 0.839-0.957) could distinguish Stanford type A patients from non-AD patients. Moreover, Th1 cells (p = 0.037) and Th17 cells (p = 0.001) were positively related to CRP, and Th17 cells (p = 0.039) were also positively associated with D-dimer in Stanford type A AD patients. Furthermore, Th17 cells were elevated in deaths compared with survivors (p = 0.001), also, it could estimate 30-day mortality risk in Stanford type A AD patients with an AUC of 0.741 (95% CI: 0.614-0.867), which was similar to the value of CRP (AUC: 0.771, 95% CI: 0.660-0.882), but lower than the value of D-dimer (AUC:

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Crp and D-dimer Are Two Well-established Biomarkers In Acutementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Th1, Th2, and Th17 cells are dysregulated, but only Th17 cells relate to C‐reactive protein, D‐dimer, and mortality risk in Stanford type A aortic dissection patients

Song

Deng

Shen

et al. 2022

Clinical Laboratory Analysis

View full text Add to dashboard Cite

show abstract

“…The post-discharge mortality in individuals with ATAAD is independently predicted by relatively high WBC on admission, according to Zhang et al ( 27 ). Ke et al also said that increased WBC can be employed as supplementary markers for postoperative in-hospital death with ATAAD ( 28 ). Elevated preoperative WBC was associated with a higher risk of death following an ATAAD procedure in this research, and this could be caused by inflammation from a vascular intima rupture, just as the difference in WBC between the two groups was statistically significant, which is in line with the findings of the outcomes of past experiments ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

Prediction of in-hospital death following acute type A aortic dissection

Chen

Bai

Liu

et al. 2023

Front. Public Health

View full text Add to dashboard Cite

BackgroundOur goal was to create a prediction model for in-hospital death in Chinese patients with acute type A aortic dissection (ATAAD).MethodsA retrospective derivation cohort was made up of 340 patients with ATAAD from Tianjin, and the retrospective validation cohort was made up of 153 patients with ATAAD from Nanjing. For variable selection, we used least absolute shrinkage and selection operator analysis, and for risk scoring, we used logistic regression coefficients. We categorized the patients into low-, middle-, and high-risk groups and looked into the correlation with in-hospital fatalities. We established a risk classifier based on independent baseline data using a multivariable logistic model. The prediction performance was determined based on the receiver operating characteristic curve (ROC). Individualized clinical decision-making was conducted by weighing the net benefit in each patient by decision curve analysis (DCA).ResultsWe created a risk prediction model using risk scores weighted by five preoperatively chosen variables [AUC: 0.7039 (95% CI, 0.643–0.765)]: serum creatinine (Scr), D-dimer, white blood cell (WBC) count, coronary heart disease (CHD), and blood urea nitrogen (BUN). Following that, we categorized the cohort's patients as low-, intermediate-, and high-risk groups. The intermediate- and high-risk groups significantly increased hospital death rates compared to the low-risk group [adjusted OR: 3.973 (95% CI, 1.496–10.552), P < 0.01; 8.280 (95% CI, 3.054–22.448), P < 0.01, respectively). The risk score classifier exhibited better prediction ability than the triple-risk categories classifier [AUC: 0.7039 (95% CI, 0.6425–0.7652) vs. 0.6605 (95% CI, 0.6013–0.7197); P = 0.0022]. The DCA showed relatively good performance for the model in terms of clinical application if the threshold probability in the clinical decision was more than 10%.ConclusionA risk classifier is an effective strategy for predicting in-hospital death in patients with ATAAD, but it might be affected by the small number of participants.

show abstract

Predictors of In-Hospital Mortality in Type A Acute Aortic Syndrome: Data From the RENADA-RO Registry

Matei,

Antohi,

Radu

et al. 2024

Heart, Lung and Circulation

View full text Add to dashboard Cite

Clinical features and risk factors of postoperative in-hospital mortality following surgical repair of Stanford type A acute aortic dissection

Cited by 11 publications

References 30 publications

Th1, Th2, and Th17 cells are dysregulated, but only Th17 cells relate to C‐reactive protein, D‐dimer, and mortality risk in Stanford type A aortic dissection patients

Th1, Th2, and Th17 cells are dysregulated, but only Th17 cells relate to C‐reactive protein, D‐dimer, and mortality risk in Stanford type A aortic dissection patients

Prediction of in-hospital death following acute type A aortic dissection

Predictors of In-Hospital Mortality in Type A Acute Aortic Syndrome: Data From the RENADA-RO Registry

Contact Info

Product

Resources

About