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. 2024 Aug 5:17:5223-5234.
doi: 10.2147/JIR.S468017. eCollection 2024.

The Pan-Immune Inflammation Value at Admission Predicts Postoperative in-hospital Mortality in Patients with Acute Type A Aortic Dissection

Xijing Yu #  1 , Yaqin Chen #  1 , Yanchun Peng  2 , Liangwan Chen  3   4 , Yanjuan Lin  2   3
Affiliations

The Pan-Immune Inflammation Value at Admission Predicts Postoperative in-hospital Mortality in Patients with Acute Type A Aortic Dissection

Xijing Yu et al. J Inflamm Res. .

Abstract

Purpose: The inflammatory response of the body is intimately linked to the quick onset and high in-hospital mortality of Acute Type A Aortic Dissection (ATAAD). The purpose of the study was to examine the connection between in-hospital mortality in patients with ATAAD upon admission and the Pan-Immune-Inflammation Value (PIV).

Patients and methods: 308 patients who were diagnosed with ATAAD between September 2018 and October 2021 at Fujian Provincial Center for Cardiovascular Medicine had their clinical data retrospectively examined. PIV was assessed at the time of study population admission, with in-hospital mortality serving as the main outcome measure. Patients were divided into two groups, the high PIV group (PIV > 1807.704) and the low PIV group (PIV < 1807.704), based on the PIV ROC curve and the best threshold of the Youden index. The clinical results of the two groups were then compared.

Results: Among ATAAD patients, postoperative in-hospital mortality was higher in the high PIV group (54.7% vs 10.6%, P < 0.001), and the high PIV group had significantly higher rates of postoperative acute kidney injury, acute liver insufficiency, and gastrointestinal hemorrhage (P < 0.05). Additionally, the high PIV group's ICU stays lasted longer than the low PIV group's (P < 0.05). The results of multifactorial logistic regression analysis, which controlled for other variables, indicated that the mechanical ventilation time (OR = 1.860, 95% CI: 1.437, 2.408; P < 0.001), the high PIV group (> 1807.704) (OR = 1.939, 95% CI: 1.257, 2.990; P = 0.003), the cardiopulmonary bypass time (OR = 1.011, 95% CI: 1.004, 1.018; P = 0.002), and the white blood cell count (OR = 1.188, 95% CI: 1.054, 1.340; P = 0.005) were independent risk factors for postoperative in-hospital mortality in ATAAD patients.

Conclusion: Postoperative death in ATAAD patients was independently predicted by high PIV levels at admission. Patients should be informed about their preoperative inflammatory status and actively participate in prompt clinical decision-making and treatment.

Keywords: Acute Type A Aortic Dissection; Cardiac surgery; In-hospital mortality; Inflammation; the Pan-Immune-Inflammation Value.

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Conflict of interest statement

The authors declare no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Study design and groups.
Figure 2
Figure 2
Cut-off of PIV for all caused mortality. PIV, the Pan-Immune-Inflammation Value.
See this image and copyright information in PMC

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