全身免疫炎症指数与急性主动脉夹层患者短期预后的关系OACSTPCD

Objective To investigate the relationship between systemic immune-inflammation index(SII)and short-term prognosis in patients with acute aortic dissection(AAD).Methods This was a retrospective cohort study.A total of 249 AAD patients admitted to the emergency department of Shanghai Changhai Hospital from June 2019 to May 2022 were enrolled and divided into the good prognosis group(192 cases)and the death group(57 cases)according to whether death occurred during hospitalization.AAD Patients were divided into four groups(SII Q1-SII Q4)based on their SII at admission,and survival rates of different SII groups were compared by Kaplan-Meier curve.Variables that showed statistically significant differences in univariate analysis were used as independent variables for Cox regression analysis to explore the risk factors for short-term prognosis in patients with AAD.Results A total of 249 AAD patients were included in this study,among whom 57 died during hospitalization,yielding a mortality rate of 22.89%.Proportion of Stanford type A,involved branch vessels,drug therapy proportion,age,D-dimer,SII and cardiac troponin T(cTnT)in the death group were significantly higher than those in the good prognosis group,while lymphocyte count in the death group was significantly lower than that in the good prognosis group(χ2/t/U=20.359,6.935,31.633,6.459,4.427,3.998,2.597,2.130;P<0.05).The Log-rank test showed that the in-hospital survival rates of SII Q2,SII Q3 and SII Q4 groups were 79.7%,70.8%,and 66.1%,respectively,significantly lower than that of SII Q1 group(92.1%)(χ2=4.262,10.501,14.021;P<0.05).Advanced age,Stanford type A,high D-dimer level,high SII stratification and surgical treatment were influencing factors for the short-term prognosis of AAD patients(P<0.05).Conclusion AAD patients in the death group have significantly higher SII level,which is an influencing factor for the in-hospital motality.Clinical attention should be paid to AAD patients with high SII levels.