Tip A Akut Aort Diseksiyonu Olan Hastalarda Trombosit Lenfosit Oranının Uzun Dönem Mortalite Tahminindeki Rolü

Abstract

Giriş: Tip A akut aort diseksiyonu (AD) yüksek morbidite ve mortalitesinden dolayı hayatı tehdit edici, vasküler acil bir durumdur. İnflamasyon ve trombozun akut aort diseksiyonu ile ilişkili olduğu gösterilmiştir. Bu çalışmanın amacı trombo-inflamatuvar bir marker olan trombosit lenfosit oranı (TLO) ile cerrahi tamire giden akut AD’li hastalar arasında uzun dönem mortalite açısından bir ilişkinin olup olmadığını araştırmaktır.

Hastalar ve Yöntem: Tek merkezli retrospektif çalışmada Stanford tip A akut AD tanılı, 163 hasta kaydedildi. Hastalar TLO’nun medyan değerine göre düşük ve yüksek TLO grupları olarak iki gruba ayrıldı. Seksen bir hasta düşük TLO’ya (≤ 115), 82 hasta yüksek TLO’ya (> 115) sahipti.

Bulgular: Uzun dönem sağkalım yüksek TLO grubunda daha az bulundu. (long rank, p= 0.024). Buna ilaveten, yüksek bir TLO düzeyi tip A akut AD’li hastalarda uzun dönem mortalitenin bağımsız bir ön gördürücüsü olduğu belirlendi. (HR: 1.008; CI: 1.002-1.013; p= 0.007).

Sonuç: TLO, tromboz ve inflamasyonun ucuz ve basit bir belirtecidir. Başvurudaki artmış seviyeleri uzun dönem mortalitenin tahmininde değerli olabilir ve tip A akut AD’li hastaların risk derecelendirilmesinde faydalı bir belirteç olarak kullanılabilir.

Keywords

• Aort diseksiyonu,inflamasyon,tromboz,mortalite,trombosit lenfosit oranı

Role of Platelet-Lymphocyte Ratio in Prediction of Long-Term Mortality in Patients with Type A Acute Aortic Dissection

Abstract

Introduction: Type A acute aortic dissection (AD) is a life-threatening vascular emergency because of its high morbidity and mortality. Inflammation and thrombosis have been showed to be associated with AD. The aim of the study was to investigate whether there is a relationship between the platelet-lymphocyte ratio (PLR), which is a thrombo-inflammatory marker, and long-term mortality in patients with acute AD who underwent surgical repair.

Patients and Methods: In this single-centre retrospective study, data of 163 patients who were diagnosed with Stanford type A acute AD were recorded. The patients were divided into two groups, namely low and high PLR groups, according to the median value of PLR. In total, 81 patients had low PLR levels (≤ 115) and 82 patients had high PLR levels (> 115).

Results: A long-term survey was found to be lesser in the high PLR group. Furthermore, a high PLR level was determined to be an independent predictor of long-term mortality in patients with type A acute AD (HR: 1.008; CI: 1.002-1.013; p= 0.007).

Conclusion: PLR is a simple and in expensive indicator of thrombosis and inflammation. On admission, its elevated levels may be valuable in the prediction of long-term mortality and may be used as a helpful marker in the risk stratification of patients with type A acute AD.

Keywords

• Aortic dissection,inflammation,thrombosis,mortality,platelet-lymphocyte ratio

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