Xin Yijing, Lyu Siqi, Wang Jingyang, Wang Yimeng, Shu Yuyuan, Liang Hanyang, Yang Yanmin
Emergency Center, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.
BMC Cardiovasc Disord. 2025 Apr 25;25(1):323. doi: 10.1186/s12872-025-04775-9.
The purpose of this study was to assess the relationship between admission inflammatory indexes neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII), and the risk of in-hospital all-cause mortality in acute aortic dissection (AAD) patients.
A retrospective analysis was conducted on 597 AAD patients (Stanford classification: Stanford type A 365 patients, Stanford type B 232 patients) at a single center. Outcomes were the incidence of in-hospital all-cause mortality. The risk of all-cause death was compared between the groups with low and high inflammatory indexes using the Kaplan-Meier curve. The association between admission inflammatory indexes and outcomes was evaluated using the Cox regression model and restricted cubic splines (RCS). Stratified analysis was performed based on AAD type, age (< 50 years or ≥ 50 years), and gender.
The Kaplan-Meier curves revealed statistically significant differences in outcomes among the low and high inflammatory indexes groups. Cox regression analysis revealed that the in-hospital mortality risk was significantly high in the high inflammatory index groups. MLR was the strongest associated with in-hospital mortality risk. The RCS curve revealed that NLR was non-linearly and J-shaped correlated with in-hospital mortality, and MLR and SII were linearly correlated with in-hospital mortality. Stratified analysis showed interactions between NLR, MLR, and SII and AAD type and age for the risk of in-hospital mortality.
Admission high inflammatory indexes were independently associated with an increased risk of in-hospital all-cause mortality in AAD patients. The inflammatory indexes NLR, MLR, and SII may be useful indicators for predicting in-hospital all-cause mortality in AAD patients.
本研究旨在评估急性主动脉夹层（AAD）患者入院时炎症指标中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）及全身免疫炎症指数（SII）与院内全因死亡风险之间的关系。
对单中心的597例AAD患者（斯坦福分型：A型365例，B型232例）进行回顾性分析。观察指标为院内全因死亡发生率。采用Kaplan-Meier曲线比较炎症指标低、高两组的全因死亡风险。使用Cox回归模型和限制性立方样条（RCS）评估入院时炎症指标与观察指标之间的关联。根据AAD类型、年龄（<50岁或≥50岁）和性别进行分层分析。
Kaplan-Meier曲线显示，炎症指标低、高两组的观察指标存在统计学显著差异。Cox回归分析显示，高炎症指标组的院内死亡风险显著更高。MLR与院内死亡风险的相关性最强。RCS曲线显示，NLR与院内死亡呈非线性J形相关，MLR和SII与院内死亡呈线性相关。分层分析显示，NLR、MLR和SII与AAD类型及年龄之间存在相互作用，影响院内死亡风险。
入院时高炎症指标与AAD患者院内全因死亡风险增加独立相关。炎症指标NLR、MLR和SII可能是预测AAD患者院内全因死亡的有用指标。
