Oncotarget

Clinical Research Papers:

Significance of the thrombo-inflammatory status-based novel prognostic score as a useful predictor for in-hospital mortality of patients with type B acute aortic dissection

Dongze Li, Lei Ye, Jing Yu, Lixia Deng, Lianjing Liang, Yan Ma, Lei Yi, Zhi Zeng, Yu Cao and Zhi Wan _

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Oncotarget. 2017; 8:79315-79322. https://doi.org/10.18632/oncotarget.18105

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Abstract

Dongze Li1,*, Lei Ye1,*, Jing Yu2, Lixia Deng2, Lianjing Liang1, Yan Ma3, Lei Yi4, Zhi Zeng1, Yu Cao1 and Zhi Wan1

1 Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, China

2 Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China

3 School of Public Health, Xinjiang Medical University, Urumqi, China

4 Department of Neurology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China

* These authors have contributed equally to this work

Correspondence to to:

Zhi Wan, email:

Keywords: acute aortic dissection, inflammation, thrombosis, prognosis

Received: November 07, 2016 Accepted: May 12, 2017 Published: May 23, 2017

Abstract

Background: Inflammation and thrombosis are associated with development and progression of acute aortic dissection (AAD). The aim of this study was to assess the prognostic significance of Simplified Thrombo-Inflammatory Prognostic Score (sTIPS), in patients with early phase type B AAD.

Methods: We retrospectively reviewed 491 patients with type B AAD between November 2012 and September 2015. sTIPS was calculated from the white blood cell count (WBC) and mean platelet volume to platelet count (MPV/PC) ratio, at the time of admission. Patients with both, WBC > 10 (109/L) and MPV/PC ratio > 7.5 (102fL/109L-1) were assigned a score of 2, while patients with high levels of either one or none of the above markers, were assigned scores of 1 and 0 respectively. Multivariable Cox regression analyses were used to investigate the associations between the score and hospital survival.

Results: Of the 491 type B AAD patients included in this analysis, 24 patients (4.9%) died during hospitalization. Kaplan-Meier analysis revealed that the cumulative mortality was significantly higher in patients with higher sTIPS (P = 0.001). Multivariable Cox regression analysis further indicated that higher sTIPS was a strong predictor of in-hospital mortality after eliminating all confounding factors (sTIPS 2: hazard ratio 4.704, 95%; confidence interval [CI] 1.184-18.685; P = 0.028; sTIPS 1: hazard ratio 1.918, 95%; CI 1.134-3.537; P = 0.045).

Conclusions: sTIPS at admission was a useful tool for stratifying the risk in type B AAD patients, for outcomes such as in-hospital mortality in the early phase.


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