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Prognostic Value of Systemic Inflammation Response Index in Acute Type A Aortic Dissection

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Abstract

Background

The study aimed to evaluate the prognostic value of preoperative systemic inflammation response index (SIRI) for acute type A aortic dissection (ATAD) following open surgery.

Methods and results

Totally, 410 ATAD patients underwent open surgery from 2019 to 2021 were enrolled in the study. Among the patients, the in-hospital mortality was 14.4%. Cox regression (95%CI 1.033–1.114p < 0.001) and receiver operating characteristic curve analysis (AUC = 0.718, p < 0.001) demonstrated the prognostic role of SIRI for in-hospital mortality after surgery. The optimal cut-off value of SIRI for in-hospital mortality was identified as 9.43 by maximally selected Log-Rank statistics. The patients were divided into high SIRI group (SIRI ≥ 9.43) and low SIRI group (SIRI < 9.43)) after the linear inverse relationship between SIRI and hazard ratio for in-hospital mortality was demonstrated by restricted cubic spline analysis (p = 0.0742). The Kaplan–Meier analysis illustrated that in-hospital mortality increased significantly in high SIRI group (p < 0.001). In addition, elevating SIRI was significantly associated with the incidence of coronary sinus tear (95%CI 1.020–4.475p = 0.044). Furthermore, the incidence rate of postoperative complications including renal failure (p < 0.001) and infection (p = 0.019) was higher in high SIRI group.

Conclusion

The study indicated that preoperative SIRI could provide strong prognostic value for in-hospital mortality in ATAD patients following open surgery. Thus, SIRI was a promising biomarker for risk stratification and management prior to open surgery.

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Acknowledgements

We declare that all authors have read and approved submission of the manuscript. Material in this manuscript has not been published and is not being considered for publication elsewhere in whole or in part in any language.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Author notes

  1. Hongjie Xu, He Wang, and Lujia Wu have contributed equally to this work.

Authors and Affiliations

  1. Department of Cardiovascular Surgery, Changhai Hospital, The Naval Medical University, 168 Changhai Road, Shanghai, 200433, China

    Hongjie Xu, He Wang, Lujia Wu, Tianyu Xu, Lin Han, Fanglin Lu, Bailing Li, Yangyong Sun & Zhiyun Xu

  2. Department of Cardiothoracic Surgery, Affiliated People’s Hospital of Jiangsu University, Zhenjiang, 212002, China

    Yangyong Sun

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  1. Hongjie Xu
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  2. He Wang
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  5. Lin Han
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Contributions

ZX, YS, and HX contributed to conceptualization; HW, LW, and TX provided methodology; HX, YS, and TX performed formal analysis and investigation; HX and YS performed writing—original draft preparation; HX, ZX, and YS performed writing—review and editing; LH, FL, and BL provided resources; ZX carried out supervision.

Corresponding authors

Correspondence to Yangyong Sun or Zhiyun Xu.

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Xu, H., Wang, H., Wu, L. et al. Prognostic Value of Systemic Inflammation Response Index in Acute Type A Aortic Dissection. World J Surg 47, 2554–2561 (2023). https://doi.org/10.1007/s00268-023-07079-1

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  • DOI: https://doi.org/10.1007/s00268-023-07079-1

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