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

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%, P = 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, P = 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.

[1]  T. Gregório,et al.  Pre-operative Neutrophil to Lymphocyte Ratio is Associated With 30 Day Death or Amputation After Revascularisation for Acute Limb Ischaemia. , 2021, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[2]  Xinglong Zheng,et al.  Association of biomarkers related to preoperative inflammatory and coagulation with postoperative in-hospital deaths in patients with type A acute aortic dissection , 2021, Scientific Reports.

[3]  N. Kim,et al.  LASSO-Based Machine Learning Algorithm for Prediction of Lymph Node Metastasis in T1 Colorectal Cancer , 2020, Cancer research and treatment : official journal of Korean Cancer Association.

[4]  Jing Wang,et al.  The elevated admission white blood cell count relates to adverse surgical outcome of acute Stanford type a aortic dissection , 2020, Journal of Cardiothoracic Surgery.

[5]  O. Soehnlein,et al.  Neutrophils as regulators of cardiovascular inflammation , 2020, Nature Reviews Cardiology.

[6]  Heesang Song,et al.  Combination of Mean Platelet Volume and Neutrophil to Lymphocyte Ratio Predicts Long-Term Major Adverse Cardiovascular Events After Percutaneous Coronary Intervention , 2019, Angiology.

[7]  D. Hermann,et al.  Polymorphonuclear Neutrophils Play a Decisive Role for Brain Injury and Neurological Recovery Poststroke. , 2019, Stroke.

[8]  B. Long,et al.  Coronary artery bypass graft surgery complications: A review for emergency clinicians , 2018, The American journal of emergency medicine.

[9]  F. Lu,et al.  Inflammation is related to preoperative hypoxemia in patients with acute Stanford type A aortic dissection. , 2018, Journal of thoracic disease.

[10]  A. von Eckardstein,et al.  Acute aortic dissection: pathogenesis, risk factors and diagnosis. , 2017, Swiss medical weekly.

[11]  K. Eagle,et al.  Acute Aortic Dissection and Intramural Hematoma: A Systematic Review. , 2016, JAMA.

[12]  Y. Okada,et al.  Adventitial CXCL1/G-CSF Expression in Response to Acute Aortic Dissection Triggers Local Neutrophil Recruitment and Activation Leading to Aortic Rupture , 2015, Circulation research.

[13]  E. Erdoğan,et al.  Neutrophil–lymphocyte ratio may predict in-hospital mortality in patients with acute type A aortic dissection , 2015, Herz.

[14]  K. Eagle,et al.  IS SIZE A GOOD PREDICTOR OF DISSECTION RISK IN PATIENTS WITH MARFAN SYNDROME OR BICUSPID AORTIC VALVES? INSIGHTS FROM THE INTERNATIONAL REGISTRY OF ACUTE AORTIC DISSECTION (IRAD) , 2012 .

[15]  E. Mohammadi,et al.  Barriers and facilitators related to the implementation of a physiological track and trigger system: A systematic review of the qualitative evidence , 2017, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[16]  F. Luo,et al.  Inflammatory response is associated with aortic dissection , 2009, Ageing Research Reviews.

[17]  K. Eagle,et al.  Long-Term Survival in Patients Presenting With Type A Acute Aortic Dissection: Insights from the International Registry of Acute Aortic Dissection (IRAD) , 2006, Circulation.

[18]  D. Milewicz,et al.  Characterization of the inflammatory and apoptotic cells in the aortas of patients with ascending thoracic aortic aneurysms and dissections. , 2006, The Journal of thoracic and cardiovascular surgery.

[19]  R. Bellomo,et al.  Acute renal failure – definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group , 2004, Critical care.

[20]  G. Chejfec,et al.  Correlation of inflammatory infiltrate with the enlargement of experimental aortic aneurysms. , 1992, Journal of vascular surgery.