Gao Yongli, Li Dongze, Cao Yu, Zhu Xingyu, Zeng Zhi, Tang Li
Department of Emergency Medicine, Laboratory of Emergency Medicine, West China Hospital.
Disaster Medical Center.
Medicine (Baltimore). 2019 Feb;98(6):e14486. doi: 10.1097/MD.0000000000014486.
Serum albumin (SA) is associated with inflammation and thrombosis, which are involved in acute aortic dissection (AAD). Our aim was to investigate the effect of SA level on survival in patients with AAD.We analyzed 777 patients with AAD. The patients were divided into hypoalbuminemia and non-hypoalbuminemia groups according to their AAD Stanford classification. Multivariable Cox regression was used to investigate the association between SA levels and in-hospital mortality in type A and B AAD.A total of 103 (13.3%) patients died in-hospital. The in-hospital mortality in type A and B patients with hypoalbuminemia was higher compared to those without (type A: 34.2% vs 13.9%, P <.001; type B: 7.9% vs 1.6%, P = .001). Kaplan-Meier analysis showed that survival was significantly lower in patients with hypoalbuminemia compared to those without, regardless of AAD type (type A: log-rank χ = 14.71; P <.001; Type B: log-rank χ = 10.42; P = .001). After adjusting for confounding factors, hypoalbuminemia was an independent predictor of in-hospital mortality in patients with either type A (HR, 2.492; 95% confidence interval [CI], 1.247-4.979; P = .010) or type B (HR, 8.729; 95% CI, 1.825-41.736; P = .007).SA is independently associated with increased in-hospital mortality in both type A and B AAD.
血清白蛋白(SA)与炎症和血栓形成相关,而炎症和血栓形成参与急性主动脉夹层(AAD)的发病过程。我们的目的是研究SA水平对AAD患者生存的影响。我们分析了777例AAD患者。根据AAD斯坦福分类将患者分为低白蛋白血症组和非低白蛋白血症组。采用多变量Cox回归分析A、B型AAD患者SA水平与院内死亡率之间的关联。共有103例(13.3%)患者在院内死亡。低白蛋白血症的A型和B型患者的院内死亡率高于非低白蛋白血症患者(A型:34.2%对13.9%,P<0.001;B型:7.9%对1.6%,P=0.001)。Kaplan-Meier分析表明,无论AAD类型如何,低白蛋白血症患者的生存率显著低于非低白蛋白血症患者(A型:对数秩检验χ=14.71;P<0.001;B型:对数秩检验χ=10.42;P=0.001)。在调整混杂因素后,低白蛋白血症是A型(HR,2.492;95%置信区间[CI],1.247-4.979;P=0.010)或B型(HR,8.729;95%CI,1.825-41.736;P=0.007)AAD患者院内死亡的独立预测因素。SA与A型和B型AAD患者院内死亡率增加独立相关。