C-Reactive Protein and Neutrophil to Lymphocyte Ratio Values in Predicting Inhospital Death in Patients with Stanford Type A Acute Aortic Dissection.

Abstract

Aortic dissection is a cardiovascular disease with high mortality and morbidity rates. The aim of this study is to investigate the role of C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR) in predicting in-hospital mortality in patients undergoing emergent surgery for Stanford type A aortic dissection. Patients operated for acute Stanford type A aortic dissection between January 2010 and December 2018 were included in the study. Patients without in-hospital mortality were classified as Group 1, and patients with mortality were classified as Group 2. One-hundred-eighteen patients were involved in the study. Patient mean age was 57 ± 11.7 years, and 89 patients (75.4%) were male. Neutrophil-to-lymphocyte ratio (NLR), white blood cell (WBC), neutrophil counts, and C-reactive protein (CRP) values at the time of admission also were found to be high in Group 2 (P = .001, .021, < .001, < .001 respectively). Total perfusion times (TPt), antegrade cerebral perfusion time (ACPt), cross-clamp time (CCt), and intensive care unit (ICU) stay periods significantly were higher in the mortality group (P < .001, < .001, = .01, and < .001, respectively). In receiver-operating characteristic (ROC) curve analysis, a cut-off level of 23 mg/L was determined for CRP levels that predict progression to mortality (area under the curve (AUC): 0.879, P < .001, 75.0% sensitivity and 58.0% specificity). Similarly, a cut-off level of 8.8 was found for NLR that predicts progression to mortality (AUC: 0.835, P < .001, 76.0% sensitivity and 61.0% specificity). As a result, we can use CRP and NLR values, which easily can be measured or calculated from blood tests to predict mortality in patients with aortic dissections, which may have serious mortal consequences.