Predictive value of inflammatory indexes in in-hospital mortality for patients with acute aortic dissection

Abstract Background The purpose of this study was to assess the relationship between admission inflammatory indexes neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII), and the risk of in-hospital all-cause mortality in acute aortic...

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Main Authors: Yijing Xin, Siqi Lyu, Jingyang Wang, Yimeng Wang, Yuyuan Shu, Hanyang Liang, Yanmin Yang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Cardiovascular Disorders
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Online Access:https://doi.org/10.1186/s12872-025-04775-9
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author Yijing Xin
Siqi Lyu
Jingyang Wang
Yimeng Wang
Yuyuan Shu
Hanyang Liang
Yanmin Yang
author_facet Yijing Xin
Siqi Lyu
Jingyang Wang
Yimeng Wang
Yuyuan Shu
Hanyang Liang
Yanmin Yang
author_sort Yijing Xin
collection DOAJ
description Abstract Background The purpose of this study was to assess the relationship between admission inflammatory indexes neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII), and the risk of in-hospital all-cause mortality in acute aortic dissection (AAD) patients. Methods A retrospective analysis was conducted on 597 AAD patients (Stanford classification: Stanford type A 365 patients, Stanford type B 232 patients) at a single center. Outcomes were the incidence of in-hospital all-cause mortality. The risk of all-cause death was compared between the groups with low and high inflammatory indexes using the Kaplan-Meier curve. The association between admission inflammatory indexes and outcomes was evaluated using the Cox regression model and restricted cubic splines (RCS). Stratified analysis was performed based on AAD type, age (< 50 years or ≥ 50 years), and gender. Results The Kaplan-Meier curves revealed statistically significant differences in outcomes among the low and high inflammatory indexes groups. Cox regression analysis revealed that the in-hospital mortality risk was significantly high in the high inflammatory index groups. MLR was the strongest associated with in-hospital mortality risk. The RCS curve revealed that NLR was non-linearly and J-shaped correlated with in-hospital mortality, and MLR and SII were linearly correlated with in-hospital mortality. Stratified analysis showed interactions between NLR, MLR, and SII and AAD type and age for the risk of in-hospital mortality. Conclusion Admission high inflammatory indexes were independently associated with an increased risk of in-hospital all-cause mortality in AAD patients. The inflammatory indexes NLR, MLR, and SII may be useful indicators for predicting in-hospital all-cause mortality in AAD patients.
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spelling doaj-art-a96f07928e4e4acb8fbd7cde7ac38f892025-08-20T03:14:05ZengBMCBMC Cardiovascular Disorders1471-22612025-04-012511810.1186/s12872-025-04775-9Predictive value of inflammatory indexes in in-hospital mortality for patients with acute aortic dissectionYijing Xin0Siqi Lyu1Jingyang Wang2Yimeng Wang3Yuyuan Shu4Hanyang Liang5Yanmin Yang6Emergency Center, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeEmergency Center, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeEmergency Center, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeEmergency Center, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeEmergency Center, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeEmergency Center, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeEmergency Center, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeAbstract Background The purpose of this study was to assess the relationship between admission inflammatory indexes neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII), and the risk of in-hospital all-cause mortality in acute aortic dissection (AAD) patients. Methods A retrospective analysis was conducted on 597 AAD patients (Stanford classification: Stanford type A 365 patients, Stanford type B 232 patients) at a single center. Outcomes were the incidence of in-hospital all-cause mortality. The risk of all-cause death was compared between the groups with low and high inflammatory indexes using the Kaplan-Meier curve. The association between admission inflammatory indexes and outcomes was evaluated using the Cox regression model and restricted cubic splines (RCS). Stratified analysis was performed based on AAD type, age (< 50 years or ≥ 50 years), and gender. Results The Kaplan-Meier curves revealed statistically significant differences in outcomes among the low and high inflammatory indexes groups. Cox regression analysis revealed that the in-hospital mortality risk was significantly high in the high inflammatory index groups. MLR was the strongest associated with in-hospital mortality risk. The RCS curve revealed that NLR was non-linearly and J-shaped correlated with in-hospital mortality, and MLR and SII were linearly correlated with in-hospital mortality. Stratified analysis showed interactions between NLR, MLR, and SII and AAD type and age for the risk of in-hospital mortality. Conclusion Admission high inflammatory indexes were independently associated with an increased risk of in-hospital all-cause mortality in AAD patients. The inflammatory indexes NLR, MLR, and SII may be useful indicators for predicting in-hospital all-cause mortality in AAD patients.https://doi.org/10.1186/s12872-025-04775-9Acute aortic dissectionInflammatory indexesNeutrophil-to-lymphocyte ratioMonocyte-to-lymphocyte ratioSystemic immune-inflammation index
spellingShingle Yijing Xin
Siqi Lyu
Jingyang Wang
Yimeng Wang
Yuyuan Shu
Hanyang Liang
Yanmin Yang
Predictive value of inflammatory indexes in in-hospital mortality for patients with acute aortic dissection
BMC Cardiovascular Disorders
Acute aortic dissection
Inflammatory indexes
Neutrophil-to-lymphocyte ratio
Monocyte-to-lymphocyte ratio
Systemic immune-inflammation index
title Predictive value of inflammatory indexes in in-hospital mortality for patients with acute aortic dissection
title_full Predictive value of inflammatory indexes in in-hospital mortality for patients with acute aortic dissection
title_fullStr Predictive value of inflammatory indexes in in-hospital mortality for patients with acute aortic dissection
title_full_unstemmed Predictive value of inflammatory indexes in in-hospital mortality for patients with acute aortic dissection
title_short Predictive value of inflammatory indexes in in-hospital mortality for patients with acute aortic dissection
title_sort predictive value of inflammatory indexes in in hospital mortality for patients with acute aortic dissection
topic Acute aortic dissection
Inflammatory indexes
Neutrophil-to-lymphocyte ratio
Monocyte-to-lymphocyte ratio
Systemic immune-inflammation index
url https://doi.org/10.1186/s12872-025-04775-9
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