He Huaping, Chai Xiangping, Zhou Yang, Pan Xiaogao, Yang Guifang
Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, China.
Int J Hypertens. 2020 Jan 7;2020:1347165. doi: 10.1155/2020/1347165. eCollection 2020.
Evidence regarding the relationship between serum lactate dehydrogenase (LDH) levels and in-hospital mortality in acute aortic dissection (AAD) patients is extremely limited. We aimed to investigate the relationship between LDH and in-hospital mortality in AAD patients.
The present study was a retrospective observational study. A total of 1526 participants with acute aortic dissection were involved in a hospital in China from January 2014 to December 2018. The target-independent variable was LDH measured at baseline, and the dependent was all-cause mortality during hospitalization. Covariates involved in this study included age, gender, body mass index (BMI), hypertension, diabetes, smoking, stroke, atherosclerosis, systolic blood pressure (SBP), diastolic blood pressure (DBP), white blood cell (WBC), hemoglobin (Hb), alanine transaminase (ALT), aspartate aminotransferase (AST), albumin (ALB), creatinine (Cr), symptom, type of AAD (Stanford), and management.
The average age of 1526 selected participants was 52.72 ± 11.94 years old, and about 80.41% of them were male. The result of the fully adjusted model showed LDH was positively associated with in-hospital mortality in AAD patients after adjusting confounders (OR = 1.09, 95% CI 1.05 to 1.13). A nonlinear relationship was detected between LDH and in-hospital mortality in AAD patients after adjusting for potential confounders (age, gender, BMI, hypertension, diabetes, stroke, atherosclerosis, smoking, symptom, SBP, DBP, WBC, Hb, ALT, AST, ALB, Cr, type of AAD (Stanford), and management), whose point was 557. The effect sizes and the confidence intervals of the left and right sides of the inflection point were 0.90 (0.74-1.10) and 1.12 (1.06-1.19), respectively. Subgroup analysis in participants showed that the relationship between LDH and in-hospital mortality was stable, and all of the value for the interaction in different subgroup were more than 0.05.
The relationship between LDH and in-hospital mortality in AAD patients is nonlinear. LDH was positively related with in-hospital mortality when LDH is more than 557.
关于急性主动脉夹层（AAD）患者血清乳酸脱氢酶（LDH）水平与院内死亡率之间关系的证据极为有限。我们旨在研究AAD患者中LDH与院内死亡率之间的关系。
本研究为回顾性观察研究。2014年1月至2018年12月期间，中国一家医院共有1526例急性主动脉夹层患者参与研究。目标自变量为基线时测量的LDH，因变量为住院期间的全因死亡率。本研究涉及的协变量包括年龄、性别、体重指数（BMI）、高血压、糖尿病、吸烟、中风、动脉粥样硬化、收缩压（SBP）、舒张压（DBP）、白细胞（WBC）、血红蛋白（Hb）、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、白蛋白（ALB）、肌酐（Cr）、症状、AAD类型（斯坦福分型）及治疗方式。
1526例入选患者的平均年龄为52.72±11.94岁，其中约80.41%为男性。完全调整模型的结果显示，在调整混杂因素后，AAD患者的LDH与院内死亡率呈正相关（OR = 1.09，95%CI为1.05至1.13）。在调整潜在混杂因素（年龄、性别、BMI、高血压、糖尿病、中风、动脉粥样硬化、吸烟、症状、SBP、DBP、WBC、Hb、ALT、AST、ALB、Cr、AAD类型（斯坦福分型）及治疗方式）后，检测到AAD患者的LDH与院内死亡率之间存在非线性关系，转折点为557。参与者的亚组分析表明，LDH与院内死亡率之间的关系是稳定的，不同亚组中交互作用的所有P值均大于0.05。
AAD患者中LDH与院内死亡率之间的关系是非线性的。当LDH大于557时，LDH与院内死亡率呈正相关。
