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. 2017 Jan;14(1):49-56.
doi: 10.11909/j.issn.1671-5411.2017.01.011.

Admission white blood cell count predicts short-term clinical outcomes in patients with uncomplicated Stanford type B acute aortic dissection

Zhao-Ran Chen  1 , Bi Huang  1 , Hai-Song Lu  2 , Zhen-Hua Zhao  3 , Ru-Tai Hui  1 , Yan-Min Yang  1 , Xiao-Han Fan  1
Affiliations

Admission white blood cell count predicts short-term clinical outcomes in patients with uncomplicated Stanford type B acute aortic dissection

Zhao-Ran Chen et al. J Geriatr Cardiol. 2017 Jan.

Abstract

Objectives: Inflammation has been shown to be related with acute aortic dissection (AAD). The present study aimed to evaluate the association of white blood cell counts (WBCc) on admission with both in-hospital and long-term all-cause mortality in patients with uncomplicated Stanford type B AAD.

Methods: From 2008 to 2010, a total of 377 consecutive patients with uncomplicated type B AAD were enrolled and then followed up. Clinical data and WBCc on admission were collected. The primary end points were in-hospital death and long-term all-cause death.

Results: The in-hospital death rate was 4.2%, and the long-term all-cause mortality rate was 6.9% during a median follow-up of 18.9 months. WBCc on admission was identified as a risk factor for in-hospital death by univariate Cox regression analysis as both a continuous variable and a categorical variable using a cut off of 11.0 × 109 cell/L (all P < 0.05). After adjusting for age, sex and other risk factors, elevated admission WBCc was still a significant predictor for in-hospital death as both a continuous variable [hazard ratio (HR): 1.052, 95% CI: 1.024-1.336, P = 0.002] and a categorical variable using a cut off of 11.0 × 109 cell/L (HR: 2.056, 95% CI: 1.673-5.253, P = 0.034). No relationship was observed between WBCc on admission and long-term all-cause death.

Conclusions: Our results indicate that elevated WBCc upon admission might be used as a predictor for increased risk of in-hospital death in uncomplicated type B AAD. There might be no predictive value of WBCc for the long-term survival of type B AAD.

Keywords: Acute aortic dissection; In-hospital mortality; Stanford type B; Survival; White blood cell.

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Figures

Figure 1.
Figure 1.. Participant flow chart.
AAD: acute aortic dissection; IQR: interquartile ranges; WBCc: white blood cell count.
Figure 2.
Figure 2.. Kaplan-Meier curve for in-hospital and long-term survival stratified by admission WBCc cut off value (11.0 × 109 cells/L).
(A): In the in-hospital (30 day) survival rate was lower in patients with elevated WBCc (> 11.0 × 109cells/L, log-rank P = 0.012); (B): the long-term survival rate was comparable in patients after discharge stratified by admission WBCc cut off value (11.0 × 109cells/L, log-rank P > 0.05). WBCc: white blood cell count.
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