Author:
Chen Wenxiu,Song Xiaochun,Hong Liang,Xu Huan,Qian Yan,Zhang Wenhao,Sun Jiakui,Shen Xiao,Liu Ying,Wang Xiang,Shi Qiankun,Liu Han,Mu Xinwei,Zhang Cui
Abstract
Abstract
Background
The aim of this study was to investigate the relationship between baseline lymphocyte-monocyte ratio (LMR) and postoperative acute kidney injury (AKI) in patients with acute type A aortic dissection (ATAAD).
Methods
ATAAD patients undergoing surgery in Nanjing First Hospital were enrolled from January 2019 to April 2021. Lymphocyte and monocyte were measured on admission. Multivariable logistic regression analyses were performed to explore the relationship between LMR and postoperative AKI. We also used receiver operating characteristic (ROC), net reclassification index (NRI) and integrated discrimination improvement (IDI) analyses to assess the predictive ability of LMR.
Results
Among the 159 recruited patients, 47 (29.6%) were diagnosed with AKI. Univariate logistic regression analysis indicated that ATAAD patients with higher levels of LMR were prone to have lower risk to develop AKI (odds ratio [OR], 0.493; 95% confidence interval [CI] 0.284–0.650, P = 0.001). After adjustment for the potential confounders, LMR remained an independent related factor with postoperative AKI (OR 0.527; 95% CI 0.327–0.815, P = 0.006). The cutoff value for LMR to predict AKI was determined to be 2.67 in the ROC curve analysis (area under curve: 0.719). NRI and IDI further confirmed the predictive capability of LMR in postoperative AKI.
Conclusion
Elevated baseline LMR levels were independently associated with lower risk of postoperative AKI in ATAAD patients.
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine,General Medicine,Surgery,Pulmonary and Respiratory Medicine
Reference32 articles.
1. Xia L, Huang L, Feng X, Xiao J, Wei X, Yu X. Chronobiological patterns of acute aortic dissection in central China. Heart. 2020;107(4):320–5.
2. Salmasi MY, Al-Saadi N, Hartley P, Jarral OA, Raja S, Hussein M, et al. The risk of misdiagnosis in acute thoracic aortic dissection: a review of current guidelines. Heart. 2020;106(12):885–91.
3. Hagiya K, Ozaki K, Nanasato M, Iguchi N, Takayama M, Shimokawa T, et al. Relationship between heart rate at discharge and long-term outcomes of surgically treated patients with type A acute aortic dissections. Circ J. 2021;85(12):2191–200.
4. Hao GW, Tu GW, Yu SJ, Luo JC, Liu K, Wang H, et al. Inhaled nitric oxide reduces the intrapulmonary shunt to ameliorate severe hypoxemia after acute type A aortic dissection surgery. Nitric Oxide. 2021;109–110:26–32.
5. De Freitas S, Rossi MJ, Abramowitz SD, Fatima J, Kiguchi MM, Vallabhaneni R, et al. Systematic review and meta-analysis of endovascular interventions for Stanford type A aortic dissection. J Vasc Surg. 2021;S0741–5214(21):00198–201.
Cited by
4 articles.
订阅此论文施引文献
订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献