身体的炎症反应与急性A型主动脉夹层(ATAAD)的快速发作和高院内死亡率密切相关。该研究的目的是检查ATAAD患者入院时的住院死亡率与泛免疫炎症值(PIV)之间的联系。
■在2018年9月至2021年10月期间在福建省心血管医学中心诊断为ATAAD的308例患者的临床资料进行了回顾性检查。PIV在研究人群入院时进行评估,以住院死亡率为主要结局指标。患者分为两组,高PIV组(PIV>1807.704)和低PIV组(PIV<1807.704),基于PIVROC曲线和优登指数的最佳阈值。然后比较两组的临床结果。
■在ATAAD患者中,高PIV组术后住院死亡率较高(54.7%vs10.6%,P<0.001),高PIV组术后急性肾损伤发生率明显增高,急性肝功能不全,消化道出血(P<0.05)。此外,高PIV组的ICU停留时间长于低PIV组(P<0.05)。多因素Logistic回归分析结果,控制其他变量,表明机械通气时间(OR=1.860,95%CI:1.437,2.408;P<0.001),高PIV组(>1807.704)(OR=1.939,95%CI:1.257,2.990;P=0.003),体外循环时间(OR=1.011,95%CI:1.004,1.018;P=0.002),白细胞计数(OR=1.188,95%CI:1.054,1.340;P=0.005)是ATAAD患者术后院内死亡的独立危险因素。
■ATAAD患者的术后死亡是入院时高PIV水平独立预测的。应告知患者术前炎症状态,并积极参与及时的临床决策和治疗。
UNASSIGNED: The inflammatory response of the body is intimately linked to the quick onset and high in-hospital mortality of Acute Type A Aortic Dissection (ATAAD). The purpose of the study was to examine the connection between in-hospital mortality in patients with ATAAD upon admission and the Pan-Immune-Inflammation Value (PIV).
UNASSIGNED: 308 patients who were diagnosed with ATAAD between September 2018 and October 2021 at Fujian Provincial Center for Cardiovascular Medicine had their clinical data retrospectively examined. PIV was assessed at the time of study population admission, with in-hospital mortality serving as the main outcome measure. Patients were divided into two groups, the high PIV group (PIV > 1807.704) and the low PIV group (PIV < 1807.704), based on the PIV ROC curve and the best threshold of the Youden index. The clinical results of the two groups were then compared.
UNASSIGNED: Among ATAAD patients, postoperative in-hospital mortality was higher in the high PIV group (54.7% vs 10.6%, P < 0.001), and the high PIV group had significantly higher rates of postoperative acute kidney injury, acute liver insufficiency, and gastrointestinal hemorrhage (P < 0.05). Additionally, the high PIV group\'s ICU stays lasted longer than the low PIV group\'s (P < 0.05). The results of multifactorial logistic regression analysis, which controlled for other variables, indicated that the mechanical ventilation time (OR = 1.860, 95% CI: 1.437, 2.408; P < 0.001), the high PIV group (> 1807.704) (OR = 1.939, 95% CI: 1.257, 2.990; P = 0.003), the cardiopulmonary bypass time (OR = 1.011, 95% CI: 1.004, 1.018; P = 0.002), and the white blood cell count (OR = 1.188, 95% CI: 1.054, 1.340; P = 0.005) were independent risk factors for postoperative in-hospital mortality in ATAAD patients.
UNASSIGNED: Postoperative death in ATAAD patients was independently predicted by high PIV levels at admission. Patients should be informed about their preoperative inflammatory status and actively participate in prompt clinical decision-making and treatment.