U-shaped relationship between platelet–lymphocyte ratio and postoperative in-hospital mortality in patients with type A acute aortic dissection

Abstract Background 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 (A...

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Autores principales:	Xi Xie, Xiangjie Fu, Yawen Zhang, Wanting Huang, Lingjin Huang, Ying Deng, Danyang Yan, Run Yao, Ning Li
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Platelet–lymphocyte ratio Type A acute aortic dissection In-hospital mortality Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/5b5d765cf98049c58e1bb7ad8096d9c7
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spelling	oai:doaj.org-article:5b5d765cf98049c58e1bb7ad8096d9c72021-12-05T12:05:17ZU-shaped relationship between platelet–lymphocyte ratio and postoperative in-hospital mortality in patients with type A acute aortic dissection10.1186/s12872-021-02391-x1471-2261https://doaj.org/article/5b5d765cf98049c58e1bb7ad8096d9c72021-11-01T00:00:00Zhttps://doi.org/10.1186/s12872-021-02391-xhttps://doaj.org/toc/1471-2261Abstract Background 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). Methods 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. Results 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). Conclusions 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.Xi XieXiangjie FuYawen ZhangWanting HuangLingjin HuangYing DengDanyang YanRun YaoNing LiBMCarticlePlatelet–lymphocyte ratioType A acute aortic dissectionIn-hospital mortalityDiseases of the circulatory (Cardiovascular) systemRC666-701ENBMC Cardiovascular Disorders, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Platelet–lymphocyte ratio Type A acute aortic dissection In-hospital mortality Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Platelet–lymphocyte ratio Type A acute aortic dissection In-hospital mortality Diseases of the circulatory (Cardiovascular) system RC666-701 Xi Xie Xiangjie Fu Yawen Zhang Wanting Huang Lingjin Huang Ying Deng Danyang Yan Run Yao Ning Li U-shaped relationship between platelet–lymphocyte ratio and postoperative in-hospital mortality in patients with type A acute aortic dissection
description	Abstract Background 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). Methods 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. Results 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). Conclusions 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.
format	article
author	Xi Xie Xiangjie Fu Yawen Zhang Wanting Huang Lingjin Huang Ying Deng Danyang Yan Run Yao Ning Li
author_facet	Xi Xie Xiangjie Fu Yawen Zhang Wanting Huang Lingjin Huang Ying Deng Danyang Yan Run Yao Ning Li
author_sort	Xi Xie
title	U-shaped relationship between platelet–lymphocyte ratio and postoperative in-hospital mortality in patients with type A acute aortic dissection
title_short	U-shaped relationship between platelet–lymphocyte ratio and postoperative in-hospital mortality in patients with type A acute aortic dissection
title_full	U-shaped relationship between platelet–lymphocyte ratio and postoperative in-hospital mortality in patients with type A acute aortic dissection
title_fullStr	U-shaped relationship between platelet–lymphocyte ratio and postoperative in-hospital mortality in patients with type A acute aortic dissection
title_full_unstemmed	U-shaped relationship between platelet–lymphocyte ratio and postoperative in-hospital mortality in patients with type A acute aortic dissection
title_sort	u-shaped relationship between platelet–lymphocyte ratio and postoperative in-hospital mortality in patients with type a acute aortic dissection
publisher	BMC
publishDate	2021
url	https://doaj.org/article/5b5d765cf98049c58e1bb7ad8096d9c7
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U-shaped relationship between platelet–lymphocyte ratio and postoperative in-hospital mortality in patients with type A acute aortic dissection

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