入院时血清总胆固醇水平对急性主动脉夹层患者院内死亡率的影响。
Impact of admission serum total cholesterol level on in-hospital mortality in patients with acute aortic dissection.
作者信息
Liu Xintian, Su Xi, Zeng Hesong
机构信息
Xintian Liu, Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Xi Su, Department of Cardiology, Wuhan Asia Heart Hospital, Wuhan, China.
出版信息
Pak J Med Sci. 2016 Jul-Aug;32(4):939-43. doi: 10.12669/pjms.324.10124.
OBJECTIVE
To find out the association between serum total cholesterol (TC) on admission and in-hospital mortality in patients with acute aortic dissection (AAD).
METHODS
From January 2007 to January 2014, we enrolled 1492 consecutive AAD patients with serum TC measured immediately on admission. Baseline characteristics and in-hospital mortality were compared between the patients with serum TC above and below the median (4.00 mmol/L). Propensity score matching (PSM) was used to account for known confounders in the study. Cox proportional hazard model was performed to calculate the hazard ratio (HR) and 95% confidence interval (CI) for admission serum TC levels.
RESULTS
With the use of PSM, 521 matched pairs of patients with AAD were yielded in this analysis due to their similar propensity scores. Patients with admission serum TC < 4.00 mmol/L, as compared with those with admission serum TC ≥ 4.00 mmol/L, had higher in-hospital mortality (11.7% vs. 5.8%; HR, 2.06; 95% CI, 1.33-3.19, P = 0.001). Stratified analysis according to Stanford classification showed that the inverse association between admission serum TC and in-hospital mortality was observed in patients with Type-A AAD (24.0% vs. 11.3%; HR, 2.18; 95% CI, 1.33 - 3.57, P = 0.002) but not in those with Type-B AAD (3.8% vs. 2.2%; HR, 1.71; 95% CI, 0.67 - 4.34, P = 0.261).
CONCLUSIONS
Lower serum TC level on admission was strongly associated with higher in-hospital mortality in patients with Type-A AAD.
目的
探究急性主动脉夹层（AAD）患者入院时血清总胆固醇（TC）与院内死亡率之间的关联。
方法
2007年1月至2014年1月，我们纳入了1492例连续的AAD患者，这些患者入院时即刻测量了血清TC。比较血清TC高于和低于中位数（4.00 mmol/L）的患者的基线特征和院内死亡率。采用倾向评分匹配（PSM）来处理研究中的已知混杂因素。进行Cox比例风险模型以计算入院血清TC水平的风险比（HR）和95%置信区间（CI）。
结果
通过PSM，本分析中产生了521对匹配的AAD患者，因为他们的倾向评分相似。入院血清TC < 4.00 mmol/L的患者与入院血清TC≥4.00 mmol/L的患者相比，院内死亡率更高（11.7%对5.8%；HR，2.06；95% CI，1.33 - 3.19，P = 0.001）。根据斯坦福分类进行的分层分析表明，A型AAD患者中观察到入院血清TC与院内死亡率之间存在负相关（24.0%对11.3%；HR，2.18；95% CI，1.33 - 3.57，P = 0.002），而B型AAD患者中未观察到（3.8%对2.2%；HR，1.71；95% CI，0.67 - 4.34，P = 0.261）。
结论
入院时较低的血清TC水平与A型AAD患者较高的院内死亡率密切相关。
Zotero 插件