尿酸与急性 A 型主动脉夹层患者院内死亡率的关系：一项回顾性单中心研究。

The relationship between uric acid and in-hospital mortality in patients with type A acute aortic dissection: A retrospective single-center study.

机构信息

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.

出版信息

Asian J Surg. 2024 Jan;47(1):229-232. doi: 10.1016/j.asjsur.2023.08.036. Epub 2023 Aug 16.

DOI:10.1016/j.asjsur.2023.08.036

PMID:37596211

Abstract

OBJECTIVE

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.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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）。