Correlation between biomarkers and in-hospital mortality in patients with acute Stanford type A aortic dissection

doi:10.3877/cma.j.issn.1674-6880.2018.02.001

Abstract

Abstract:

Objective

To investigate the relationship between biomarkers and in-hospital mortality in patients with acute Stanford type A aortic dissection (ATAAD).

Methods

A total of 310 inpatients with ATAAD emergency surgery were selected from the Department of Cardiac Surgery in Beijing Anzhen Hospital, Capital Medical University from December 2014 to July 2015. They were divided into the survival group (279 cases) and death group (31 cases) according to their survival condition during hospitalization. The general information of the age, gender, past history (including hypertension, diabetes, family history of coronary atherosclerotic heart disease, hyperlipidemia, smoking, alcohol consumption and aortic history), the expression of biomarkers on admission [including cardiac troponin I, creatine kinase isoenzyme (CK-MB), D-dimer, leukocyte count and left ventricle eject fraction (LVEF)] and the condition at discharge (death or survival) of these two groups were compared. The factors that may affect in-hospital mortality of ATAAD inpatients were included in the multivariate Logistic regression to analyze the risk factors affecting their in-hospital mortality.

Results

There were significant differences of the cardiac troponin I [0.071 (0.013, 1.532) μg/L vs. 0.052 (0.014, 1.133) μg/L], D-dimer[1 104 (454, 2 576) μg/L vs. 1 827 (752, 3 475) μg/L], and leukocyte count [9 (7, 12) × 10⁹/L vs. 12 (8, 17) ×10⁹/L] between these two groups of inpatients with ATAAD emergency operation (U=3 202.000, 3 316.000, 3 118.000; P=0.036, 0.041, 0.011), while there was no significant difference in the other data (all P > 0.05). The multivariate Logistic regression analysis showed that the leukocyte count [OR=1.133, 95%CI (1.041, 1.233), P=0.004] was an independent risk factor for inhospital mortality in patients undergoing ATAAD emergency surgery.

Conclusion

The leukocyte count is an independent risk factor for in-hospital mortality in patients with ATAAD emergency surgery.

Key words: Biomarker, Acute Stanford type A aotic dissection, In-hospital mortality, Prognosis

Xiaonan He, Guanqi Zhao, Yanlong Zhang, Lizhong Sun, Shaoping Nie. Correlation between biomarkers and in-hospital mortality in patients with acute Stanford type A aortic dissection[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2018, 11(02): 73-77.

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References 24

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组别	例数	年龄（岁，±s）	性别比（例，男/女）	高血压[例（%）]	糖尿病[例（%）]	CHD家族史[例（%）]	高脂血症[例（%）]	吸烟[例（%）]	饮酒[例（%）]
生存组	279	48 ± 11	196/83	190（88.8）	7（2.5）	15（5.4）	1（0.4）	125（44.8）	41（14.7）
死亡组	31	48 ± 12	25/6	24（77.4）	0	0	0	17（54.8）	7（22.6）
t/χ²值	?	0.087	1.473	1.133	0.796	-	-	1.132	1.326
P值	?	0.931	0.225	0.287	0.799	0.198	0.900	0.287	0.374

组别	例数	年龄（岁，±s）	性别比（例，男/女）	高血压[例（%）]	糖尿病[例（%）]	CHD家族史[例（%）]	高脂血症[例（%）]	吸烟[例（%）]	饮酒[例（%）]
生存组	279	48 ± 11	196/83	190（88.8）	7（2.5）	15（5.4）	1（0.4）	125（44.8）	41（14.7）
死亡组	31	48 ± 12	25/6	24（77.4）	0	0	0	17（54.8）	7（22.6）
t/χ²值	?	0.087	1.473	1.133	0.796	-	-	1.132	1.326
P值	?	0.931	0.225	0.287	0.799	0.198	0.900	0.287	0.374

组别	例数	肌钙蛋白I（μg/L）	CK-MB（μg/L）	D-二聚体（μg/L）	白细胞计数（× 10⁹/L）	LVEF（%，±s）
生存组	279	0.071（0.013，1.532）	1.8（0.9，9.9）	1 104（454，2 576）	9（7，12）	60 ± 7
死亡组	31	0.052（0.014，1.133）	2.2（1.2，14.3）	1 827（752，3 475）	12（8，17）	59 ± 8
U/t值	?	3 202.000	3 589.000	3 316.000	3 118.000	1.363
P值	?	0.036	0.120	0.041	0.011	0.174

组别	例数	肌钙蛋白I（μg/L）	CK-MB（μg/L）	D-二聚体（μg/L）	白细胞计数（× 10⁹/L）	LVEF（%，±s）
生存组	279	0.071（0.013，1.532）	1.8（0.9，9.9）	1 104（454，2 576）	9（7，12）	60 ± 7
死亡组	31	0.052（0.014，1.133）	2.2（1.2，14.3）	1 827（752，3 475）	12（8，17）	59 ± 8
U/t值	?	3 202.000	3 589.000	3 316.000	3 118.000	1.363
P值	?	0.036	0.120	0.041	0.011	0.174

危险因素	回归系数	标准误	Wald值	P值	OR值	95%CI
危险因素	回归系数	标准误	Wald值	P值	OR值	下限	上限
肌钙蛋白I	0.040	0.020	4.166	0.051	1.041	1.002	1.082
D-二聚体	0.000	0.000	3.013	0.083	1.000	1.000	1.000
白细胞计数	0.125	0.043	8.380	0.004	1.133	1.041	1.233

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