The predictive values of monocyte–lymphocyte ratio in postoperative acute kidney injury and prognosis of patients with Stanford type A aortic dissection
ObjectivesPostoperative acute kidney injury (pAKI) is a serious complication of Stanford type A aortic dissection (TAAD) surgery, which is significantly associated with the inflammatory response. This study aimed to explore the relationship between blood count-derived inflammatory markers (BCDIMs) a...
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1195421/full |
| _version_ | 1797773553742905344 |
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| author | Yubin Chen Kaiyi Dong Cheng Fang Hui Shi Wenjie Luo Can-e Tang Can-e Tang Fanyan Luo Fanyan Luo |
| author_facet | Yubin Chen Kaiyi Dong Cheng Fang Hui Shi Wenjie Luo Can-e Tang Can-e Tang Fanyan Luo Fanyan Luo |
| author_sort | Yubin Chen |
| collection | DOAJ |
| description | ObjectivesPostoperative acute kidney injury (pAKI) is a serious complication of Stanford type A aortic dissection (TAAD) surgery, which is significantly associated with the inflammatory response. This study aimed to explore the relationship between blood count-derived inflammatory markers (BCDIMs) and pAKI and to construct a predictive model for pAKI.MethodsPatients who underwent TAAD surgery were obtained from our center and the Medical Information Mart for Intensive Care (MIMIC)-IV database. The differences in preoperative BCDIMs and clinical outcomes of patients with and without pAKI were analyzed. Logistic regression was used to construct predictive models based on preoperative BCDIMs or white cell counts (WCCs). The performance of the BCDIMs and WCCs models was evaluated and compared using the receiver operating characteristic (ROC) curve, area under the ROC curve (AUC), Hosmer–Lemeshow test, calibration plot, net reclassification index (NRI), integrated discrimination improvement index (IDI), and decision curve analysis (DCA). The Kaplan–Meier curves were applied to compare the survival rate between different groups.ResultsThe overall incidence of pAKI in patients who underwent TAAD surgery from our center was 48.63% (124/255). The presence of pAKI was associated with longer ventilation time, higher incidence of cerebral complications and postoperative hepatic dysfunction, and higher in-hospital mortality. The results of the logistic regression indicated that the monocyte–lymphocyte ratio (MLR) was an independent risk factor for pAKI. The BCDIMs model had good discriminating ability, predictive ability, and clinical utility. In addition, the performance of the BCDIMs model was significantly better than that of the WCCs model. Analysis of data from the MIMIC-IV database validated that MLR was an independent risk factor for pAKI and had predictive value for pAKI. Finally, data from the MIMIC-IV database demonstrated that patients with a high MLR had a significantly poor 28-day survival rate when compared to patients with a low MLR.ConclusionOur study suggested that the MLR is an independent risk factor for pAKI. A predictive model based on BCDIMs had good discriminating ability, predictive ability, and clinical utility. Moreover, the performance of the BCDIMs model was significantly better than that of the WCCs model. Finally, a high MLR was significantly associated with poor short-term survival of patients who underwent TAAD surgery. |
| first_indexed | 2024-03-12T22:08:08Z |
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| language | English |
| last_indexed | 2024-03-12T22:08:08Z |
| publishDate | 2023-07-01 |
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| spelling | doaj.art-82d3a630cb4040f4b6639c40239d193c2023-07-24T09:53:39ZengFrontiers Media S.A.Frontiers in Immunology1664-32242023-07-011410.3389/fimmu.2023.11954211195421The predictive values of monocyte–lymphocyte ratio in postoperative acute kidney injury and prognosis of patients with Stanford type A aortic dissectionYubin Chen0Kaiyi Dong1Cheng Fang2Hui Shi3Wenjie Luo4Can-e Tang5Can-e Tang6Fanyan Luo7Fanyan Luo8Department of Cardiac Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDepartment of Cardiac Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDepartment of Cardiac Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDepartment of Cardiac Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDepartment of Cardiac Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDepartment of Endocrinology, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaThe Institute of Medical Science Research, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDepartment of Cardiac Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaNational Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaObjectivesPostoperative acute kidney injury (pAKI) is a serious complication of Stanford type A aortic dissection (TAAD) surgery, which is significantly associated with the inflammatory response. This study aimed to explore the relationship between blood count-derived inflammatory markers (BCDIMs) and pAKI and to construct a predictive model for pAKI.MethodsPatients who underwent TAAD surgery were obtained from our center and the Medical Information Mart for Intensive Care (MIMIC)-IV database. The differences in preoperative BCDIMs and clinical outcomes of patients with and without pAKI were analyzed. Logistic regression was used to construct predictive models based on preoperative BCDIMs or white cell counts (WCCs). The performance of the BCDIMs and WCCs models was evaluated and compared using the receiver operating characteristic (ROC) curve, area under the ROC curve (AUC), Hosmer–Lemeshow test, calibration plot, net reclassification index (NRI), integrated discrimination improvement index (IDI), and decision curve analysis (DCA). The Kaplan–Meier curves were applied to compare the survival rate between different groups.ResultsThe overall incidence of pAKI in patients who underwent TAAD surgery from our center was 48.63% (124/255). The presence of pAKI was associated with longer ventilation time, higher incidence of cerebral complications and postoperative hepatic dysfunction, and higher in-hospital mortality. The results of the logistic regression indicated that the monocyte–lymphocyte ratio (MLR) was an independent risk factor for pAKI. The BCDIMs model had good discriminating ability, predictive ability, and clinical utility. In addition, the performance of the BCDIMs model was significantly better than that of the WCCs model. Analysis of data from the MIMIC-IV database validated that MLR was an independent risk factor for pAKI and had predictive value for pAKI. Finally, data from the MIMIC-IV database demonstrated that patients with a high MLR had a significantly poor 28-day survival rate when compared to patients with a low MLR.ConclusionOur study suggested that the MLR is an independent risk factor for pAKI. A predictive model based on BCDIMs had good discriminating ability, predictive ability, and clinical utility. Moreover, the performance of the BCDIMs model was significantly better than that of the WCCs model. Finally, a high MLR was significantly associated with poor short-term survival of patients who underwent TAAD surgery.https://www.frontiersin.org/articles/10.3389/fimmu.2023.1195421/fulltype A aortic dissectionmonocyte-lymphocyte ratiopostoperative acute kidney injurypredictive modelrisk factor |
| spellingShingle | Yubin Chen Kaiyi Dong Cheng Fang Hui Shi Wenjie Luo Can-e Tang Can-e Tang Fanyan Luo Fanyan Luo The predictive values of monocyte–lymphocyte ratio in postoperative acute kidney injury and prognosis of patients with Stanford type A aortic dissection Frontiers in Immunology type A aortic dissection monocyte-lymphocyte ratio postoperative acute kidney injury predictive model risk factor |
| title | The predictive values of monocyte–lymphocyte ratio in postoperative acute kidney injury and prognosis of patients with Stanford type A aortic dissection |
| title_full | The predictive values of monocyte–lymphocyte ratio in postoperative acute kidney injury and prognosis of patients with Stanford type A aortic dissection |
| title_fullStr | The predictive values of monocyte–lymphocyte ratio in postoperative acute kidney injury and prognosis of patients with Stanford type A aortic dissection |
| title_full_unstemmed | The predictive values of monocyte–lymphocyte ratio in postoperative acute kidney injury and prognosis of patients with Stanford type A aortic dissection |
| title_short | The predictive values of monocyte–lymphocyte ratio in postoperative acute kidney injury and prognosis of patients with Stanford type A aortic dissection |
| title_sort | predictive values of monocyte lymphocyte ratio in postoperative acute kidney injury and prognosis of patients with stanford type a aortic dissection |
| topic | type A aortic dissection monocyte-lymphocyte ratio postoperative acute kidney injury predictive model risk factor |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1195421/full |
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