Prognostic Value of Systemic Inflammation Response Index in Acute Type A Aortic Dissection

Abstract

AbstractBackgroundThe study aimed to evaluate the prognostic value of preoperative systemic inflammation response index (SIRI) for acute type A aortic dissection (ATAD) following open surgery.Methods and resultsTotally, 410 ATAD patients underwent open surgery from 2019 to 2021 were enrolled in the study. Among the patients, the in‐hospital mortality was 14.4%. Cox regression (95%CI 1.033–1.114p < 0.001) and receiver operating characteristic curve analysis (AUC = 0.718, p < 0.001) demonstrated the prognostic role of SIRI for in‐hospital mortality after surgery. The optimal cut‐off value of SIRI for in‐hospital mortality was identified as 9.43 by maximally selected Log‐Rank statistics. The patients were divided into high SIRI group (SIRI ≥ 9.43) and low SIRI group (SIRI < 9.43)) after the linear inverse relationship between SIRI and hazard ratio for in‐hospital mortality was demonstrated by restricted cubic spline analysis (p = 0.0742). The Kaplan–Meier analysis illustrated that in‐hospital mortality increased significantly in high SIRI group (p < 0.001). In addition, elevating SIRI was significantly associated with the incidence of coronary sinus tear (95%CI 1.020–4.475p = 0.044). Furthermore, the incidence rate of postoperative complications including renal failure (p < 0.001) and infection (p = 0.019) was higher in high SIRI group.ConclusionThe study indicated that preoperative SIRI could provide strong prognostic value for in‐hospital mortality in ATAD patients following open surgery. Thus, SIRI was a promising biomarker for risk stratification and management prior to open surgery.