The Journal of Practical Medicine >

2025 , Vol. 41 >Issue 17: 2755 - 2760

DOI: https://doi.org/10.3969/j.issn.1006-5725.2025.17.021

Medical Examination and Clinical Diagnosis

D⁃dimer/Alb ratio， IL⁃6 and FDP jointly predict poor outcomes post type A dissection

  • Yunfang ZHANG ,
  • Zheng LI ,
  • Xiaogai NIE ,
  • Yun GUAN ,
  • Qi CHEN ,
  • Yong YUAN
Expand
  • Department of Medical Laboratory，Yan'an Hospital Affiliated to Kunming Medical University，Kunming 650051，Yunnan，China

Received date: 2025-05-16

  Online published: 2025-09-05

Fold

Abstract

Objective To analyze and evaluate the early warning efficacy of D?dimer/albumin ratio （DAR） combined with interleukin?6 （IL?6） and fibrin degradation products （FDP） in the postoperative treatment of acute Stanford type A aortic dissection （ATAAD）. Methods A retrospective cohort study was conducted on 284 ATAAD patients who underwent the Sun′s procedure at our hospital from July 2024 to March 2025. Patients were divided into a non?adverse outcome group （n = 196） and an adverse outcome group （n = 88） based on the occurrence of postoperative complications within 30 days， including acute renal failure requiring dialysis， secondary thoracotomy for hemostasis， severe neurological complications， multiple organ failure， or all?cause mortality. Preoperative baseline data， perioperative parameters， and laboratory indicators were collected via the electronic medical record system. The Mann?Whitney U test was used to compare the differences between groups for continuous variables that did not conform to the normal distribution， and Chi?square test or Fisher's exact test was selected for statistical difference analysis according to the frequency distribution characteristics of categorical variables. On the basis of univariate analysis， multivariate logistic regression analysis was used to screen independent risk factors. Results Statistically significant differences were observed between the non?adverse and adverse outcome group in age， cardiopulmonary bypass time， lactate dehydrogenase （LDH）， IL?6， D?dimer （D?D）， FDP， and DAR levels （P < 0.05）. Multivariate analysis revealed that DAR， IL?6， D?D， FDP， and prolonged cardiopulmonary bypass time were independent risk factors for adverse postoperative outcomes （P < 0.05）. Combined detection analysis demonstrated that the combination of DAR， IL?6， FDP， and cardiopulmonary bypass time yielded the highest predictive efficacy， with an area under the ROC curve of 0.886 （95%CI： 0.846 ~ 0.927）. Conclusion The combination of DAR， IL?6， FDP， and cardiopulmonary bypass time effectively predicts adverse postoperative outcomes in ATAAD patients. This biomarker panel may serve as a robust predictive tool for postoperative risk stratification.

Key words： stanford type A aortic dissection; adverse outcomes; biomarkers; cohort studies; logistic regression

Cite this article

Yunfang ZHANG , Zheng LI , Xiaogai NIE , Yun GUAN , Qi CHEN , Yong YUAN . D⁃dimer/Alb ratio， IL⁃6 and FDP jointly predict poor outcomes post type A dissection[J]. The Journal of Practical Medicine, 2025 , 41(17) : 2755 -2760 . DOI: 10.3969/j.issn.1006-5725.2025.17.021

References

[1] NIENABER C A， CLOUGH R E. Management of acute aortic dissection［J］. Lancet，2015，385（9970）：800-811. doi:10.1016/s0140-6736(14)61005-9
[2] HARRIS K M， STRAUSS C E， EAGLE K A， et al. Correlates of delayed recognition and treatment of acute type A aortic dissection： the International Registry of Acute Aortic Dissection （IRAD）［J］. Circulation，2011，124（18）：1911-1918. doi:10.1161/circulationaha.110.006320
[3] XIE L F， XIE Y L， WU Q S， et al. A predictive model for postoperative adverse outcomes following surgical treatment of acute type A aortic dissection based on machine learning［J］. J Clin Hypertens，2024，26（3）：251-261. doi:10.1111/jch.14774
[4] HOU P， XIA L， XIN F R， et al. The correlation and predictive value of Hb， RDW and their association for short-term and long-term mortality in patients with acute aortic dissection［J］. Front Cardiovasc Med，2024，11：1444498. doi:10.3389/fcvm.2024.1444498
[5] WEI L S， XIE H L， WANG Q W， et al. The prognostic value of preoperative D-dimer to albumin ratio for over all survival and progression-free survival in colorectal cancer［J］. Front Physiol，2024，15：1369855. doi:10.3389/fphys.2024.1369855
[6] LI F， REN Y T， FAN J C， et al. The predictive value of the preoperative albumin-to-fibrinogen ratio for postoper ative hospital length of stay in liver cancer patients［J］. Cancer Med，2023，12（20）：20321-20331. doi:10.1002/cam4.6606
[7] ISSELBACHER E M， PREVENTZA O， BLACK J H， et al. 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease： A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines［J］. Circulation， 2022，146（24）：e334-e482.
[8] 中华医学会糖尿病学分会. 中国2型糖尿病防治指南（2020年版）［J］. 中华糖尿病杂志，2021，13（4）：315-409.
[9] 国家心血管病中心，中国心血管健康与疾病报告编写组，胡盛寿. 中国心血管健康与疾病报告2023概要［J］. 中国循环杂志，2024，39（7）：625-660.
[10] 国家心血管系统疾病医疗质量控制中心. 2023年国家医疗服务与质量安全报告［M］. 北京：中国协和医科大学出版社，2024.
[11] GAWINECKA J， SCHOENRATH F， VON ECKARDSTEIN A. Acute aortic dissection： Pathogenesis， risk factors and diagnosis［J］. Swiss Med Wkly， 2017，147：w14489. doi:10.4414/smw.2017.14489
[12] LIN H， CHANG Y， ZHOU H， et al. Early results of frozen elephant trunk in acute type-A dissection in 1445 patients［J］. Int J Cardiol，2023，389：131213. doi:10.1016/j.ijcard.2023.131213
[13] 林天晓，陈星，孟维朋，等. 急性A型主动脉夹层体外循环术中氧输送与术后病死率相关性研究［J］. 中国心血管病研究，2023，21（11）：976-981.
[14] JIAO R， LU X R， DING H， et al. Prognosis factors for death within 90 days of discharge in patients with acute kidney injury requiring continuous renal replacement therapy after surgery for Stanford type A acute aortic dissection［J］. Chin J Surg，2022，60（5）：466-471.
[15] HUANG M J， LIAN Y J， ZENG Z Y， et al. D-dimer， C-reactive protein and matrix metalloproteinase 9 for prediction of type A aortic dissection patient survival［J］. ESC Heart Fail，2024，11（1）：147-154. doi:10.1002/ehf2.14552
[16] 屈冰，张楠，化召辉，等. D-二聚体与C反应蛋白对Stanford A型主动脉夹层动脉瘤患者术后远期预后的预测价值［J］. 实用癌症杂志，2024，39（2）：327-330.
[17] TANG Z W， LIU H， SHAO Y F. Efficacy of CRP in combination with D-dimer in predicting adverse post operative outcomes of patients with acute Stanford type A aortic dissection［J］. J Cardiothorac Surg，2022，17（1）：71. doi:10.1186/s13019-022-01818-6
[18] SUN L， DING P P， MAO W L，et al. D-Dimer-to-Albumin Ratio： A Novel Indicator to Predict Poor Outcomes in Patients with HBV-Associated Decompensated Cirrhosis［J］. Biomed Res Int，2022，2022：9062383. doi:10.1155/2022/9062383
[19] WEI L S， XIE H L， WANG Q W，et al. The prognostic value of preoperative D-dimer to albumin ratio for over all survival and progression-free survival in colorectal cancer［J］. Front Physiol，2024，15：1369855. doi:10.3389/fphys.2024.1369855
[20] SEO J S， KIM Y W， LEE Y S，et al. Usefulness of the d-dimer to albumin ratio for risk assessment in patients with acute variceal bleeding at the emergency department： Retrospective observational study［J］. BMC Emerg Med，2022，22（1）：135. doi:10.1186/s12873-022-00696-4
[21] WANG X， ZHANG Y， WANG Y X，et al. The neutrophil percentage-to-albumin ratio is associated with all-cause mortality in patients with chronic heart failure［J］. BMC Cardiovasc Disord，2023，23（1）：568. doi:10.1186/s12872-023-03472-9
[22] XU S， WU Z， LIU Y， et al. Influence of Preoperative Serum Albumin on AcuteKidney Injury after Aortic Surgery for Acute Type A Aortic Dissection：A Retrospective Cohort Study［J］. J Clin Med， 2023， 12（4）： 1581. doi:10.3390/jcm12041581
[23] 姬翠，王琴英，王蕾，等. 以家庭为中心模式下的认知行为干预在主动脉夹层术后患者延续护理中的应用［J］. 实用医学杂志，2024，40（4）：566-570.
[24] SI Y， DUAN W X， XIE J G， et al. Biomarkers for prediction of neurological complications after acute Stanford type A aortic dissection： A systematic review and meta-analysis［J］. PloS one，2023，18（2）：e0281352. doi:10.1371/journal.pone.0281352
[25] ZHANG Y， YANG YY， GUO J H，et al. Risk factors for early death after surgery in patients with acute Stanford type A aortic dissection： A systematic review and meta-analysis［J］. Int J Cardiol，2023，377：33-41. doi:10.1016/j.ijcard.2022.12.013
Options
Outlines

/

〈 〉