Department of Cardiac Surgery, Wuhan Asia Heart Hospital Affiliated with the Wuhan University of Science and Technology, Wuhan, Hubei, PR China; Wuhan Clinical Research Center for Cardiomyopathy, Wuhan, Hubei, PR China.
Department of Cardiac Surgery, Wuhan Asia Heart Hospital Affiliated with the Wuhan University of Science and Technology, Wuhan, Hubei, PR China; Wuhan Clinical Research Center for Cardiomyopathy, Wuhan, Hubei, PR China.
Asian J Surg. 2024 Jan;47(1):229-232. doi: 10.1016/j.asjsur.2023.08.036. Epub 2023 Aug 16.
To measure the preoperative uric acid (UA) concentration in patients with type A aortic dissection (TAAD), and to assess its value in predicting in-hospital mortality.
A total of 747 patients with TAAD between January 2016 and December 2022 were enrolled. The patients were divided into a survivor group and a non-survivor group. The clinical data of the two groups were compared. Univariate and multiple logistic regression analyses were performed to determine risk factors related to in-hospital mortality.
Compared with survivors, non-survivors had significantly higher serum uric acid levels (486.84 ± 127.59 vs 419.49 ± 141.02, P = 0.040). The incidence of in-hospital death increased along with higher UA levels (3.8% vs 0.7%, P = 0.007). Serum UA ≥ 373.5 μmol/L had 89.5% sensitivity and 41.3% specificity for predicting in-hospital death (area under the curve = 0.659, 95% CI: 0.554-0.765, P < 0.05). In the multivariable logistic model, Serum UA ≥ 373.5 μmol/L was independently associated with in-hospital mortality (OR = 1.022, 95% CI: 1.000-1.044, P = 0.048).
Serum UA resulted as an independent predictor of adverse prognosis in patients with TAAD, and thus could be used as an effective tool for the risk-stratification of patients with TAAD.
测量急性 A 型主动脉夹层（TAAD）患者的术前尿酸（UA）浓度，并评估其预测院内死亡率的价值。
纳入 2016 年 1 月至 2022 年 12 月期间的 747 例 TAAD 患者。将患者分为幸存者组和非幸存者组。比较两组的临床资料。采用单因素和多因素 logistic 回归分析确定与院内死亡率相关的危险因素。
与幸存者相比，非幸存者的血清尿酸水平显著升高（486.84±127.59 vs 419.49±141.02，P=0.040）。随着 UA 水平的升高，院内死亡率的发生率也随之升高（3.8% vs 0.7%，P=0.007）。血清 UA≥373.5μmol/L 预测院内死亡的敏感性为 89.5%，特异性为 41.3%（曲线下面积=0.659，95%可信区间：0.554-0.765，P<0.05）。在多变量 logistic 模型中，血清 UA≥373.5μmol/L 与院内死亡率独立相关（OR=1.022，95%可信区间：1.000-1.044，P=0.048）。
血清 UA 是 TAAD 患者不良预后的独立预测因素，因此可作为 TAAD 患者风险分层的有效工具。
