U-shaped relationship between platelet-lymphocyte ratio and postoperative in-hospital mortality in patients with type A acute aortic dissection.
U-shaped relationship between platelet-lymphocyte ratio and postoperative in-hospital mortality in patients with type A acute aortic dissection.
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A型急性主动脉夹层患者血小板淋巴细胞比值与术后院内死亡率的U型关系
DOI：
10.1186/s12872-021-02391-x
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发表时间：
2021-11-30
影响因子：
2.1
通讯作者：
Li N
中科院分区：
文献类型：
--
作者：
Xie X;Fu X;Zhang Y;Huang W;Huang L;Deng Y;Yan D;Yao R;Li N
血小板-淋巴细胞比率（PLR）是一种新的炎症标志物，通常与院内死亡风险增加相关。我们的目的是调查PLR与A型急性主动脉夹层（AAAD）患者术后住院死亡风险之间的关系。 将2014年1月至2019年5月在中南大学湘雅医院接受AAAD急诊手术的患者（n = 270）分为三个基于PLR的三分之一。我们使用多元回归分析来评估PLR对住院死亡率的独立影响，并使用平滑曲线拟合和调整混杂因素的分段回归模型来分析PLR与住院死亡风险之间的阈值效应。总的术后住院死亡率为13.33%。调整混杂因素后，中PLR三分位数的院内死亡风险最低（比值比[OR] = 0.20，95%置信区间[CI] = 0.06-0.66）。在平滑样条拟合后，我们观察到PLR和住院死亡风险之间的U形关系。当PLR < 108时，PLR每降低1个单位，住院死亡风险增加10%（OR = 0.90，P = 0.001）。当PLR在108 ~ 188之间时，死亡风险最低（OR = 1.02，P = 0.288）。当PLR > 188时，PLR每增加1个单位，住院死亡风险增加6%（OR = 1.06，P = 0.045）。AAAD患者的PLR与住院死亡率之间存在U形关系，最低住院死亡风险的最佳PLR范围为108-188。PLR可能是预测AAAD患者院内死亡风险的有用术前预后工具，并可确保风险分层和早期治疗启动。
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.
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影响因子：
4.6
作者：
Helgason, Dadi;Helgadottir, Solveig;Gudbjartsson, Tomas
通讯作者：
Gudbjartsson, Tomas
影响因子：
1.3
作者：
Li, Shuwen;Lu, Jiakai;Jin, Mu
通讯作者：
Jin, Mu
影响因子：
39.3
作者：
Erbel, Raimund;Aboyans, Victor;Vrints, Christiaan J. M.
通讯作者：
Vrints, Christiaan J. M.
DOI：
10.11909/j.issn.1671-5411.2015.05.021
发表时间：
2015-09
期刊：
Journal of geriatric cardiology : JGC
影响因子：
--
作者：
Xia L;Li JH;Zhao K;Wu HY
通讯作者：
Wu HY
DOI：
10.2147/copd.s141760
发表时间：
2017
影响因子：
2.8
作者：
Yao C;Liu X;Tang Z
通讯作者：
Tang Z