Department of Blood Transfusion, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Clinical Transfusion Research Center, Central South University, Hunan Province, 87 Xiangya Road, Changsha, 410008, China.
Department of Cardiac Surgery, Xiangya Hospital, Central South University, Hunan Province, Changsha, China.
BMC Cardiovasc Disord. 2021 Nov 30;21(1):569. doi: 10.1186/s12872-021-02391-x.
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).
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.
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).
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.
血小板-淋巴细胞比值（PLR）是一种新的炎症标志物，通常与住院期间死亡率风险增加相关。我们旨在探讨 PLR 与急性 A 型主动脉夹层（AAAD）患者术后住院期间死亡率风险之间的关系。
2014 年 1 月至 2019 年 5 月，在中南大学湘雅医院接受急诊手术治疗的 270 例 AAAD 患者根据 PLR 分为三个基于三分位的组。我们使用多元回归分析评估 PLR 对住院期间死亡率的独立影响，并通过平滑曲线拟合和调整混杂因素的分段回归模型分析 PLR 与住院期间死亡率风险之间的阈值效应。
总体术后住院期间死亡率为 13.33%。调整混杂因素后，中 PLR 三分位组的住院期间死亡率风险最低（比值比 [OR] = 0.20，95%置信区间 [CI] = 0.06-0.66）。我们观察到 PLR 与住院期间死亡率风险之间存在 U 型关系，应用平滑样条拟合后。当 PLR < 108 时，PLR 每降低 1 单位，住院期间死亡率风险增加 10%（OR = 0.90，P = 0.001）。当 PLR 在 108 至 188 之间时，死亡率风险最低（OR = 1.02，P = 0.288）。当 PLR > 188 时，PLR 每增加 1 单位，住院期间死亡率风险增加 6%（OR = 1.06，P = 0.045）。
AAAD 患者的 PLR 与住院期间死亡率之间存在 U 型关系，PLR 最佳范围为 108-188，住院期间死亡率风险最低。PLR 可能是预测 AAAD 患者住院期间死亡率风险的有用术前预后工具，并能确保风险分层和早期治疗启动。
