Prediction of in-hospital mortality in patients with aortic dissection: a new inflammation-related biomarker

Abstract

Background: Acute aortic dissection (AAD) is a rare cardiovascular emergency condition associated with high mortality. Neutrophil lymphocyte ratio (NLR) is an inflammation-related biomarker. Studies on NLR suggest that NLR is instrumental in predicting prognosis in patients with AAD. Hyperglycemia is associated with impaired hemostasis, and may induce endothelial dysfunction, oxidative stress, and inflammatory response. The authors developed a neutrophil-lymphocyte glycemic index (NLGI). This study aims to explore the potential of the NLGI in improving the prediction of mortality risk in patients hospitalized with AAD. Methods: Designed as retrospective observational research, this study was conducted on patients admitted to and diagnosed with AAD at the emergency department (ED) between 2017 and 2024. Patients aged 18 years and older who were surgically treated and had a confirmed diagnosis of AAD by thoracoabdominal computed tomography (CT) angiography were included in the study. Results: A total of 73 patients were included in the study. The patients’ ages ranged from 37 to 97 years, with a mean age of 67.53 ± 14.10 years. Of the patients, 72.6% were men. In-hospital mortality occurred in 33 patients. Receiver Operating Characteristics (ROC) analysis was performed to investigate the performance of the variables in predicting in-hospital mortality. NLGI (Area Under Curve (AUC): 0.725) had the best performance, followed by neutrophil glycemic index (NGI, AUC: 0.699) and NLR (AUC: 0.683). Conclusions: NLGI was the best-performing marker in predicting in-hospital mortality. As a predictor of poor prognosis, NLGI can guide clinicians in identifying the critical patient group.