Prognostic Value of Platelet-to-Platelet Distribution Width Ratio in Postoperative Patients with Type A Acute Aortic Dissection

Abstract

Objective: Acute type A aortic dissection (AAD) is a serious life-threatening cardiovascular emergency with high in-hospital mortality without aggressive clinical treatment. The study intended to identify the relationship between platelet (PLT) to platelet distribution width (PDW) ratio (PPR) and in-hospital mortality in postoperative patients with type A AAD. Methods: A total of 171 type A AAD patients were recruited in this retrospective study from January 2017 to December 2019. Receiver operating characteristics (ROC) were exploited to determine the best cut-off value of PPR, and then patients were sub-grouped into the low-PPR group and high-PPR group, according to the optimal value of PPR. Finally, univariate, and multivariate analyses were carried out to examine the prognostic value of PPR. Results: The value of PPR was 9.76, and the mortality was statistically higher in the low-PPR group than in the high-PPR group (29.1% vs. 6.0%, P < 0.01). The area under the ROC curve (AUC) of PPR was 0.724 (95% CI, 0.633-0.815; P < 0.001) with a 56.4% sensitivity and 80.6% specificity. Multivariate analysis showed that serum PPR was an independent factor associated with in-hospital mortality (hazard ratio (HR): 1.151; 95% confidence interval (CI): 1.035 -1.297; P = 0.010). Conclusion: Serum PPR can be used as an independent predictor of in-hospital mortality in postoperative patients with type A AAD.