Journal Article

Predictive value of inflammatory indexes in in-hospital mortality for patients with acute aortic dissection

Xin, Yijing, Yang, Yanmin, Wang, Jingyang, Liang, Hanyang, Wang, Yimeng, Lyu, Siqi, Shu, Yuyuan

2025

Overview

Background 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. Methods 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. Results 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. Conclusion 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.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Acute aortic dissection / Acute Disease / Adult / Age / Aged / Angiology / Aortic Aneurysm - blood / Aortic Aneurysm - diagnosis / Aortic Aneurysm - diagnostic imaging / Aortic Aneurysm - immunology / Aortic Aneurysm - mortality / Aortic dissection / Aortic Dissection - blood / Aortic Dissection - diagnosis / Aortic Dissection - diagnostic imaging / Aortic Dissection - immunology / Aortic Dissection - mortality / Biomarkers / Biomarkers - blood / Blood / Blood Transfusion Medicine / Cardiac Surgery / Cardiology / Care and treatment / China / Chronic illnesses / Coronary vessels / Diagnosis / Dissecting aneurysm / Dissection / Fatalities / Female / Forecasts and trends / Health risk assessment / Hospital Mortality / Hospitals / Humans / Immune response / Inflammation / Inflammation - blood / Inflammation - diagnosis / Inflammation - immunology / Inflammation - mortality / Inflammation Mediators - blood / Inflammatory indexes / Internal Medicine / Leukocytes (neutrophilic) / Lymphocyte Count / Lymphocytes / Lymphocytes - immunology / Male / Medical prognosis / Medicine / Medicine & Public Health / Methods / Middle Aged / Monocyte-to-lymphocyte ratio / Monocytes / Monocytes - immunology / Mortality / Neutrophil-to-lymphocyte ratio / Neutrophils / Neutrophils - immunology / Patients / Predictive Value of Tests / Prevention / Prognosis / Retrospective Studies / Risk Assessment / Risk Factors / Software / Statistical analysis / Systemic immune-inflammation index / Time Factors