Association of Platelet to Lymphocyte and Neutrophil to Lymphocyte Ratios with In-Hospital Mortality in Patients with Type A Acute Aortic Dissection

Abstract Objective: To evaluate the relationship between neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) with in-hospital mortality in type A acute aortic dissection (AAD). Methods: A total of 96 patients who presented to the emergency department between January 2013 and June 2018 with a diagnosis of type A AAD were enrolled in this study. White blood cell count subtypes such as NLR and PLR were calculated at the time of admission. The end point was in-hospital mortality. Results: Of the 96 type A AAD patients included in this analysis, 17 patients (17.7%) died during hospitalization. NLR and PLR were significantly elevated in patients with type A AAD (P<0.001 and <0.001, respectively). Based on the receiver operating characteristic curve, the best NLR cut-off value to predict in-hospital mortality was 9.74, with 70.6% sensitivity and 76.8% specificity, whereas the best PLR cut-off value was 195.8, with 76.5% sensitivity and 78.1% specificity. Conclusion: Admission NLR and PLR levels were important risk factors and independently associated with in-hospital mortality of type A AAD patients.

摘要
研究目的：评估中性粒细胞与淋巴细胞比值（neutrophil to lymphocyte ratio, NLR）、血小板与淋巴细胞比值（platelet to lymphocyte ratio, PLR）与A型急性主动脉夹层（type A acute aortic dissection, AAD）患者院内死亡率的相关性。
研究方法：本研究纳入2013年1月至2018年6月于急诊科就诊且确诊为A型AAD的96例患者。于入院时计算NLR、PLR等白细胞计数亚型相关指标。本研究的终点为院内死亡率。
研究结果：纳入本分析的96例A型AAD患者中，17例（17.7%）于住院期间死亡。A型AAD患者的NLR与PLR水平均显著升高（分别P<0.001和P<0.001）。基于受试者工作特征曲线（receiver operating characteristic curve, ROC），预测院内死亡率的最佳NLR截断值为9.74，灵敏度为70.6%，特异度为76.8%；而最佳PLR截断值为195.8，灵敏度为76.5%，特异度为78.1%。
研究结论：入院时的NLR与PLR水平是重要的危险因素，且与A型AAD患者的院内死亡率独立相关。