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. 2021 Aug 11:8:704345.
doi: 10.3389/fsurg.2021.704345. eCollection 2021.

The Predictive Role of Lymphocyte-to-Monocyte Ratio in Acute Kidney Injury in Acute Debakey Type I Aortic Dissection

Xiaochun Ma  1   2 , Shanghao Chen  1   2 , Yan Yun  3 , Diming Zhao  1   2 , Jinzhang Li  1   2 , Zezhong Wu  1   2 , Yanwu Liu  1   2 , Hechen Shen  1   2 , Huibo Ma  4 , Zhengjun Wang  1   2 , Chengwei Zou  1   2 , Haizhou Zhang  1   2
Affiliations

The Predictive Role of Lymphocyte-to-Monocyte Ratio in Acute Kidney Injury in Acute Debakey Type I Aortic Dissection

Xiaochun Ma et al. Front Surg. .

Abstract

Background: The post-operative acute kidney injury (AKI) represents a common complication in the Acute Debakey Type I Aortic Dissection (ADTIAD) and predicts a poorer prognosis. The clinical evidence is scarce supporting the predictive value of the pre-operative lymphocyte-to-monocyte ratio (LMR) in post-operative AKI in ADTIAD. Methods: In this retrospective cohort study, 190 consecutive patients with ADTIAD enrolled for surgical treatment between January 1, 2013, and December 31, 2018. The diagnosis of AKI followed the Kidney Disease: Improving Global Outcomes guidelines (KDIGO). Pre-operative LMR and other possible risk factors were analyzed for their prognostic value in the post-operative AKI in ADTIAD. Results: The subjects were assigned to the low-LMR and high-LMR groups according to the median value of pre-operative LMR. For post-operative AKI, the incidence and the severity in the low-LMR group were statistically different from that of the high-LMR group. Besides, the lower LMR was statistically associated with the more extended ICU stay and intubation time and higher incidences of ischemic stroke and in-hospital mortality. Additionally, in the multivariable analysis, the pre-operative LMR was an independent predictor for post-operative AKI in ADTIAD. A predictive model for post-operative AKI in ADTIAD was established incorporating LMR. Conclusions: LMR is an independent prognostic indicator incorporated into the predictive model with other risk factors to predict the post-operative AKI in ADTIAD.

Keywords: acute Debakey type I aortic dissection; acute kidney injury; lymphocyte-to-monocyte ratio; predictive model; risk factor.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of exclusion and enrollment of study patients. Describes the exclusion and enrollment of study patients.
Figure 2
Figure 2
The incidence and severity of post-operative AKI in the low-LMR group and high-LMR group in ADTIAD. Depicts the incidence of AKI and severity (stages 1, 2, and 3) in the low-LMR group and high-LMR group in ADTIAD. (A) Incidence of AKI in the low-LMR group and high-LMR group in ADTIAD. (B) Severity of AKI (stages 1, 2, and 3) in the low-LMR group and high-LMR group in ADTIAD. (C) CRRT use in the low-LMR group and high-LMR group in ADTIAD. AKI, Acute Kidney Injury; LMR, Lymphocyte-to-Monocyte Ratio; CRRT, Continuous Renal Replacement Therapy. ***P < 0.001, n.s., no statistical difference.
Figure 3
Figure 3
The ROC curve of the predictive model of post-operative AKI incorporating LMR in ADTIAD. This figure shows the ROC curve of predictive models of post-operative AKI incorporating LMR in ADTIAD. AKI, Acute Kidney Injury; LMR, Lymphocyte-to-Monocyte Ratio; ROC, Receiver Operating Characteristic.
See this image and copyright information in PMC

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