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Neutrophil–lymphocyte ratio may predict in-hospital mortality in patients with acute type A aortic dissection

Neutrophilen–Lymphozyten-Verhältnis als möglicher Prädiktor der stationären Mortalität bei Aortendissektion Typ A

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Abstract

Introduction

Inflammation has been reported to be associated with aortic dissection (AD), from the development to the prognosis of AD. In this study we aimed to find the role of the neutrophil-lymphocyte ratio (NLR) in the prediction of clinical events in patients with acute AD type A.

Patients and methods

The study comprised 37 patients who were hospitalized at our center between 2009 and 2013 with the diagnosis of acute AD type A.

Results

The mean NLR was significantly higher in patients with pericardial effusion than those without effusion (15.6 ± 11.4 vs. 7.5 ± 4.8, p = 0.005). An NLR value > 8.51 yielded an area under the curve (AUC) value of 0.829 [95 % confidence interval (CI) 0.674–0.984, p = 0.004], which demonstrated a sensitivity of 77 % and specificity of 74 % for the prediction of mortality.

Conclusions

The novel inflammatory marker NLR could be used to predict pericardial effusion and in-hospital mortality in patients with acute AD type A.

Zusammenfassung

Einleitung

Zum Zusammenhang von Inflammation und Aortendissektion (AD) ist publiziert worden, von ihrer Entwicklung einer AD bis zu ihrer Prognose. Ziel der Studie war es, die Rolle des Verhältnisses von Neutrophilen zu Lymphozyten („neutrophil/lymphocyte ratio“, NLR) in der Prädiktion von klinischen Ereignissen bei Patienten mit akuter AD vom Typ A zu eruieren.

Methoden

Die Studienpopulation bestand aus 37 Patienten, die zwischen 2009 und 2013 mit der Diagnose akute AD Typ A in unsere stationäre Behandlung aufgenommen worden waren.

Ergebnisse

Bei Patienten mit Pleuraerguss war die NLR signifikant höher als bei Patienten ohne Erguss (15,6 ± 11,4 vs. 7,5 ± 4,8, p = 0,005). Der NLR-Wert > 8,51 ergab einen AUC („area under the curve“)-Wert von 0,829 (95 %-KI 0,674–0,984; p = 0,004), entsprechend einer Sensitivität von 77 % und einer Spezifität von 74 % für die Prädiktion der Mortalität.

Fazit

Der neue Inflammationsmarker NLR ermöglicht bei akuter AD vom Typ A eine Prädiktion von Perikarderguss und stationärer Mortalität.

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Compliance with ethical guidelines

Conflict of interest. S. Karakoyun, M.O. Gürsoy, T. Akgün, L. Öcal, M. Kalçık, M. Yesin, E. Erdoğans, S. Külahçıoğlu, R.B. Bakal, C. Köksal, M. Yıldız, and M. Özkan state that there are no conflicts of interest. All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients.

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Authors and Affiliations

  1. Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey

    S. Karakoyun MD, M.O. Gürsoy, T. Akgün, L. Öcal, M. Kalçık, M. Yesin, E. Erdoğan, S. Külahçıoğlu, R.B. Bakal, M. Yıldız & M. Özkan

  2. Department of Cardiovascular Surgery, Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey

    C. Köksal

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  1. S. Karakoyun MD
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  2. M.O. Gürsoy
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  3. T. Akgün
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  4. L. Öcal
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  5. M. Kalçık
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  8. S. Külahçıoğlu
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Correspondence to S. Karakoyun MD.

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Karakoyun, S., Gürsoy, M., Akgün, T. et al. Neutrophil–lymphocyte ratio may predict in-hospital mortality in patients with acute type A aortic dissection. Herz 40, 716–721 (2015). https://doi.org/10.1007/s00059-014-4121-2

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  • DOI: https://doi.org/10.1007/s00059-014-4121-2

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