Emergency Department of West China Hospital, Sichuan University/West China School of Nursing, Sichuan University.
Institute of Disaster Medicine, Sichuan University
Heart Surg Forum. 2021 Jan 19;24(1):E048-E054. doi: 10.1532/hsf.3417.
Acute aortic dissection (AAD) is an emergency disease with high misdiagnosis rate and mortality. The aim of the present study is to explore the impact of blood-related biomarkers, specifically D-dimer, on in-hospital outcomes of patients with AAD.
A total of 345 patients in our hospital from December 2013 to April 2017 were included. The cutoff value for D-dimer and LDL-C were set as 5.9mg/l and 1.45 mg/l, respectively. The univariate and multivariate logistic regression models were used to identify the independently prognostic predictors.
The results showed that patients with type A AAD had higher risk of in-hospital mortality compared with those with type B disease. Moreover, results revealed the type A AAD (OR 6.382, 95%CI: 2.423 to 16.812), D-dimer (OR 2.160, 95%CI: 1.072 to 4.350), and LDL-C (OR 0.373, 95%CI: 0.148 to 0.940) were independently associated with in-hospital mortality. Subgroup analysis suggested that D-dimer (OR 2.295, 95%CI: 1.140 to 4.622) was an independently prognostic factor in type A AAD.
In summary, D-dimer ≥5.9 mg/L and type A AAD were independently associated with in-hospital mortality in AAD patients. Moreover, subgroup analysis proved that the elevated D-dimer was related to poor prognosis in type A AAD.
急性主动脉夹层(AAD)是一种误诊率和死亡率均较高的急症。本研究旨在探讨血液相关生物标志物(尤其是 D-二聚体)对 AAD 患者住院结局的影响。
选取 2013 年 12 月至 2017 年 4 月我院收治的 345 例患者。将 D-二聚体和 LDL-C 的截断值分别设定为 5.9mg/L 和 1.45mg/L。采用单因素和多因素 logistic 回归模型来识别独立的预后预测因素。
结果显示,与 B 型患者相比,A型 AAD 患者住院期间的死亡风险更高。此外,研究结果表明,A型 AAD(OR 6.382,95%CI:2.423 至 16.812)、D-二聚体(OR 2.160,95%CI:1.072 至 4.350)和 LDL-C(OR 0.373,95%CI:0.148 至 0.940)与住院期间的死亡率独立相关。亚组分析表明,D-二聚体(OR 2.295,95%CI:1.140 至 4.622)是 A 型 AAD 的独立预后因素。
综上所述,D-二聚体≥5.9mg/L 和 A 型 AAD 与 AAD 患者的住院死亡率独立相关。此外,亚组分析证实,D-二聚体升高与 A 型 AAD 的不良预后相关。