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中性粒细胞计数对急性A型主动脉夹层患者院内死亡率的预后意义。

Prognostic significance of neutrophil count on in-hospital mortality in patients with acute type A aortic dissection.

作者信息

Feng Weiqi, Li Huili, Wang Qiuji, Li Chenxi, Wu Jinlin, Yang Jue, Fan Ruixin

机构信息

Department of Cardiovascular Surgery, Guangdong Provincial Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.

School of Medicine, South China University of Technology, Guangzhou, China.

出版信息

Front Cardiovasc Med. 2023 Mar 3;10:1095646. doi: 10.3389/fcvm.2023.1095646. eCollection 2023.

Abstract

BACKGROUNDS

The goal of this study was to assess the impact of neutrophil count, in patients with acute type A aortic dissection (ATAAD).

METHODS

This study retrospectively collected data from patients between September 2017 and June 2021. Youden's index was used to determine the optimal cut-off value for the neutrophil count and patients were divided into two subgroups. A restricted cubic spline (RCS) was used to model the relationship between variables and in-hospital mortality. The least absolute shrinkage and selection operator (LASSO) method and multivariate logistic regression analyses were used to investigate the independent prognostic factors for in-hospital mortality in patients with ATAAD.

RESULTS

A total of 467 patients were enrolled in this study. In-hospital mortality was 7.28%. The group with elevated neutrophil counts had significantly higher mortality than the group with decreased neutrophil counts (10.8% vs. 3.2%,  = 0.02). This data shows that elevated neutrophil count was significantly associated with in-hospital mortality (OR 3.07, 95% CI 1.22-7.62,  = 0.02).

CONCLUSIONS

Neutrophil count is an independent risk factor for in-hospital mortality in patients with ATAAD. It is an effective inflammatory index, which can be individualized for patients.

摘要

背景

本研究的目的是评估急性A型主动脉夹层(ATAAD)患者中性粒细胞计数的影响。

方法

本研究回顾性收集了2017年9月至2021年6月期间患者的数据。使用约登指数确定中性粒细胞计数的最佳临界值,并将患者分为两个亚组。使用受限立方样条(RCS)对变量与院内死亡率之间的关系进行建模。采用最小绝对收缩和选择算子(LASSO)方法和多因素逻辑回归分析来研究ATAAD患者院内死亡的独立预后因素。

结果

本研究共纳入467例患者。院内死亡率为7.28%。中性粒细胞计数升高组的死亡率显著高于中性粒细胞计数降低组(10.8%对3.2%,P = 0.02)。该数据表明,中性粒细胞计数升高与院内死亡率显著相关(OR 3.07,95%CI 1.22 - 7.62,P = 0.02)。

结论

中性粒细胞计数是ATAAD患者院内死亡的独立危险因素。它是一种有效的炎症指标,可为患者进行个体化评估。

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