Prognostic Value of Postoperative Platelet to Mean Platelet Volume Ratio for In-hospital Mortality in Type A Acute Aortic Dissection Patients.

Abstract

Surgical treatment is the most effective method to improve the prognosis of type A acute aortic dissection (TAAAD) patients. Thus, this investigation aimed to evaluate the value of postoperative platelet to mean platelet volume ratio (PMR) in predicting in-hospital mortality in postoperative TAAAD patients and to compare it with preoperative PMR.A retrospective study (171 postoperative patients) was conducted in the hospital from January 2017 to December 2019. Clinical (age, gender, and outcome of the patients' in-hospital mortality), preoperative PMR, and postoperative laboratory results were gathered. The area under the receiver operating characteristic curve (AUC) and logistic regression were employed.Preoperative and postoperative PMR levels were higher in the survivors than in the nonsurvivors (13.44 ± 7.15 versus 9.15 ± 4.05, P = 0.002; 12.02 ± 6.79 versus 6.85 ± 2.42, P < 0.001; respectively). Multivariate logistic regression indicated that postoperative PMR was an independent factor even adjusted with different variables. Moreover, postoperative PMR had the highest area under the receiver operating characteristic curve (AUC) (AUC: 0.778, 95% CI: 0.708-0.838, P < 0.001), with the best prognostic accuracy, followed by preoperative PMR (AUC: 0.721, 95% CI: 0.648-0.787, P < 0.001). The best cutoff value for postoperative PMR was 9.9206, with a high sensitivity (90.3%) and specificity (55.7%).Postoperative PMR should serve as an independent index to predict in-hospital mortality in TAAAD patients. In addition, postoperative PMR are superior to preoperative PMR to recognize high-risk patients.