The short-term prognostic value of serum platelet to hemoglobin in patients with type A acute aortic dissection

Wang, Yu; Qiao, Tengfei; Zhou, Jun

doi:10.1177/0267659120982226

Cited by 6 publications

(5 citation statements)

References 27 publications

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“…Bedel et al [ 16 ] reported a correlation between high PLR (> 195.8) and increased in-hospital mortality in patients with AAAD. However, Yang et al [ 17 ] found that a high preoperative PLR (≥ 150) was associated with a low incidence of postoperative adverse events. Contrastingly, Sbarouni et al found no association between the PLR and mortality [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Bedel et al [ 16 ] reported that a high PLR at admission was associated with increased in-hospital mortality in patients with AAAD. However, Yang et al [ 17 ] suggested that a high preoperative PLR in patients with AAAD is correlated with a better prognosis. In addition, a study demonstrated that the PLR could be used for the differential diagnoses of similar diseases, but its usefulness in prognosis assessment should be further investigated [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

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U-shaped relationship between platelet–lymphocyte ratio and postoperative in-hospital mortality in patients with type A acute aortic dissection

Xie

Zhang

et al. 2021

BMC Cardiovasc Disord

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Background The platelet-lymphocyte ratio (PLR), a novel inflammatory marker, is generally associated with increased in-hospital mortality risk. We aimed to investigate the association between PLR and postoperative in-hospital mortality risk in patients with type A acute aortic dissection (AAAD). Methods Patients (n = 270) who underwent emergency surgery for AAAD at Xiangya Hospital of Central South University between January 2014 and May 2019 were divided into three PLR-based tertiles. We used multiple regression analyses to evaluate the independent effect of PLR on in-hospital mortality, and smooth curve fitting and a segmented regression model with adjustment of confounding factors to analyze the threshold effect between PLR and in-hospital mortality risk. Results The overall postoperative in-hospital mortality was 13.33%. After adjusting for confounders, in-hospital mortality risk in the medium PLR tertile was the lowest (Odds ratio [OR] = 0.20, 95% confidence interval [CI] = 0.06–0.66). We observed a U-shaped relationship between PLR and in-hospital mortality risk after smoothing spline fitting was applied. When PLR < 108, the in-hospital mortality risk increased by 10% per unit decrease in PLR (OR = 0.90, P = 0.001). When the PLR was between 108 and 188, the mortality risk was the lowest (OR = 1.02, P = 0.288). When PLR > 188, the in-hospital mortality risk increased by 6% per unit increase in PLR (OR = 1.06, P = 0.045). Conclusions There was a U-shaped relationship between PLR and in-hospital mortality in patients with AAAD, with an optimal PLR range for the lowest in-hospital mortality risk of 108–188. PLR may be a useful preoperative prognostic tool for predicting in-hospital mortality risk in patients with AAAD and can ensure risk stratification and early treatment initiation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

U-shaped relationship between platelet–lymphocyte ratio and postoperative in-hospital mortality in patients with type A acute aortic dissection

Xie

Zhang

et al. 2021

BMC Cardiovasc Disord

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“…In our study, patients with a CPB duration of ≥257.5 min were more likely to suffer severe ALI after surgery than those with a CBP duration of <257.5. Decreased hemoglobin levels have been associated with poor prognosis in a variety of cardiovascular diseases 15–17 . However, interestingly, hemoglobin levels of ≤139.5 g/L were determined to be associated with a reduction in postoperative severe ALI risk in this study.…”

Section: Discussionmentioning

confidence: 51%

“…Decreased hemoglobin levels have been associated with poor prognosis in a variety of cardiovascular diseases. [15][16][17] However, interestingly, hemoglobin levels of ≤139.5 g/L were determined to be associated with a reduction in postoperative severe ALI risk in this study.…”

Section: Discussionmentioning

confidence: 54%

Prediction model for postoperative severe acute lung injury in patients undergoing acute type A aortic dissection surgery

Wang

Feng

Kuang

et al. 2022

Journal of Cardiac Surgery

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Objective: This study aimed to establish a risk assessment model to predict postoperative severe acute lung injury (ALI) risk in patients with acute type A aortic dissection (ATAAD). Methods: Consecutive patients with ATAAD admitted to our hospital were included in this retrospective assessment and placed in the postoperative severe ALI and nonsevere ALI groups based on the presence or absence of ALI within 72 h postoperatively (oxygen index [OI] ≤ 100 mmHg). Patients were then randomly divided into training and validation groups in a ratio of 8:2. Univariate and multivariate stepwise forward logistic regression analyses were used to statistically assess data and establish the prediction model. The prediction model's effectiveness was evaluated via 10-fold cross-validation of the validation group to facilitate the construction of a nomogram. Results: After the screening, 479 patients were included in the study: 132 (27.6%) in the postoperative severe ALI group and 347 (72.4%) in the postoperative nonsevere ALI group. Based on multivariate logistics regression analyses, the following variables were included in the model: coronary heart disease, cardiopulmonary bypass (CPB) ≥ 257.5 min, left atrium diameter ≥ 35.5 mm, hemoglobin ≤ 139.5 g/L, preCPB OI ≤ 100 mmHg, intensive care unit OI ≤ 100 mmHg, left ventricular posterior wall thickness ≥ 10.5 mm, and neutrophilic granulocyte percentage ≥ 0.824. The area under the receiver operating characteristic (ROC) curve of the modeling group was 0.805 and differences between observed and predicted values were not deemed statistically significant via the Hosmer-Lemeshow test (χ 2 = 6.037, df = 8, p = .643).For the validation group, the area under the ROC curve was 0.778, and observed and predicted value differences were insignificant when assessed using the Hosmer-Lemeshow test (χ 2 = 3.3782, df = 7; p = .848). The average 10-fold crossvalidation score was 0.756. Conclusions:This study established a prediction model and developed a nomogram to determine the risk of postoperative severe ALI after ATAAD. Variables used in the model were easy to obtain clinically and the effectiveness of the model was good.

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“…3,4) Our previous study also indicated that platelet to hemoglobin could be acted as an independent factor to predict the short outcome for TAAAD patients. 5) However, indicators that are precise, simple, practical, and easily available are still lacking, especially for patients who have undergone surgical treatment.…”

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confidence: 99%

Prognostic Value of Postoperative Platelet to Mean Platelet Volume Ratio for In-hospital Mortality in Type A Acute Aortic Dissection Patients

Xia

Dong

et al. 2023

Int. Heart J.

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Surgical treatment is the most effective method to improve the prognosis of type A acute aortic dissection (TAAAD) patients. Thus, this investigation aimed to evaluate the value of postoperative platelet to mean platelet volume ratio (PMR) in predicting in-hospital mortality in postoperative TAAAD patients and to compare it with preoperative PMR.A retrospective study (171 postoperative patients) was conducted in the hospital from January 2017 to December 2019. Clinical (age, gender, and outcome of the patients' in-hospital mortality), preoperative PMR, and postoperative laboratory results were gathered. The area under the receiver operating characteristic curve (AUC) and logistic regression were employed.Preoperative and postoperative PMR levels were higher in the survivors than in the nonsurvivors (13.44 ± 7.15 versus 9.15 ± 4.05, P = 0.002; 12.02 ± 6.79 versus 6.85 ± 2.42, P < 0.001; respectively). Multivariate logistic regression indicated that postoperative PMR was an independent factor even adjusted with different variables. Moreover, postoperative PMR had the highest area under the receiver operating characteristic curve (AUC) (AUC: 0.778, 95% CI: 0.708-0.838, P < 0.001), with the best prognostic accuracy, followed by preoperative PMR (AUC: 0.721, 95% CI: 0.648-0.787, P < 0.001). The best cutoff value for postoperative PMR was 9.9206, with a high sensitivity (90.3%) and specificity (55.7%).Postoperative PMR should serve as an independent index to predict in-hospital mortality in TAAAD patients. In addition, postoperative PMR are superior to preoperative PMR to recognize high-risk patients.

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The short-term prognostic value of serum platelet to hemoglobin in patients with type A acute aortic dissection

Cited by 6 publications

References 27 publications

U-shaped relationship between platelet–lymphocyte ratio and postoperative in-hospital mortality in patients with type A acute aortic dissection

U-shaped relationship between platelet–lymphocyte ratio and postoperative in-hospital mortality in patients with type A acute aortic dissection

Prediction model for postoperative severe acute lung injury in patients undergoing acute type A aortic dissection surgery

Prognostic Value of Postoperative Platelet to Mean Platelet Volume Ratio for In-hospital Mortality in Type A Acute Aortic Dissection Patients

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