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

Yıl 2017, Cilt: 20 Sayı: 1, 24 - 29, 03.04.2017

Mehmet Mustafa Tabakcı Anıl Avcı Cüneyt Toprak Göksel Açar Abdulkadir Uslu Uğur Arslantaş Serdar Demir Deniz Günay Elnur Alizade Mehmet Altuğ Tuncer Mustafa Akçakoyun

Öz

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.

Anahtar Kelimeler

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

Öz

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.

Anahtar Kelimeler

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

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