Association of lymphopenia and RDW elevation with risk of mortality in acute aortic dissection

作者全名："Yu, Dan; Chen, Peng; Zhang, Xueyan; Wang, Hongjie; Dhuromsingh, Menaka; Wu, Jinxiu; Qin, Bingyu; Guo, Suping; Zhang, Baoquan; Li, Chunwen; Zeng, Hesong"

作者地址："[Yu, Dan; Chen, Peng; Wang, Hongjie; Dhuromsingh, Menaka; Zeng, Hesong] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Div Cardiol,Dept Internal Med, Wuhan, Peoples R China; [Yu, Dan; Wang, Hongjie; Dhuromsingh, Menaka; Zeng, Hesong] Hubei Prov Engn Res Ctr Vasc Intervent Therapy, Wuhan, Peoples R China; [Yu, Dan; Guo, Suping] Zhengzhou Univ, Peoples Hosp, Henan Prov Peoples Hosp, Dept Cardiac Intens Care Unit, Zhengzhou, Peoples R China; [Zhang, Xueyan; Qin, Bingyu] Zhengzhou Univ, Peoples Hosp, Henan Prov Peoples Hosp, Henan Key Lab Crit Care Med,Dept Crit Care Med, Zhengzhou, Peoples R China; [Wu, Jinxiu; Zhang, Baoquan] Xinxiang Med Univ, Affiliated Hosp 3, Dept Crit Care Med, Xinxiang, Peoples R China; [Guo, Suping] Zhengzhou Univ, Cent China Fuwai Hosp, Fuwai Cent China Cardiovasc Hosp, Dept Cardiac Intens Care Unit, Zhengzhou, Peoples R China; [Li, Chunwen] Chongqing Med Univ, Affiliated Hosp 2, Dept Emergency Med, Chongqing, Peoples R China"

通信作者："Zeng, HS (通讯作者)，Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Div Cardiol,Dept Internal Med, Wuhan, Peoples R China.; Zeng, HS (通讯作者)，Hubei Prov Engn Res Ctr Vasc Intervent Therapy, Wuhan, Peoples R China.; Guo, SP (通讯作者)，Zhengzhou Univ, Peoples Hosp, Henan Prov Peoples Hosp, Dept Cardiac Intens Care Unit, Zhengzhou, Peoples R China.; Qin, BY (通讯作者)，Zhengzhou Univ, Peoples Hosp, Henan Prov Peoples Hosp, Henan Key Lab Crit Care Med,Dept Crit Care Med, Zhengzhou, Peoples R China.; Zhang, BQ (通讯作者)，Xinxiang Med Univ, Affiliated Hosp 3, Dept Crit Care Med, Xinxiang, Peoples R China.; Guo, SP (通讯作者)，Zhengzhou Univ, Cent China Fuwai Hosp, Fuwai Cent China Cardiovasc Hosp, Dept Cardiac Intens Care Unit, Zhengzhou, Peoples R China.; Li, CW (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Emergency Med, Chongqing, Peoples R China."

来源：PLOS ONE

ESI学科分类：Multidisciplinary

WOS号：WOS:000954452200032

JCR分区：Q1

影响因子：2.9

年份：2023

卷号：18

期号：3

开始页：　

结束页：　

文献类型：Article

关键词：　

摘要："ObjectiveThe study aimed to investigate whether lymphopenia and red blood cell distribution width (RDW) elevation are associated with an increased risk of mortality in acute aortic dissection (AAD). MethodsThis multicenter retrospective cohort study enrolled patients diagnosed with AAD by aortic computed tomographic angiography (CTA) from 2010 to 2021 in five teaching hospitals in central-western China. Cox proportional hazards regression and Kaplan-Meier curves were used in univariable and multivariable models. Clinical outcomes were defined as all-cause in-hospital mortality, while associations were evaluated between lymphopenia, accompanied by an elevated RDW, and risk of mortality. ResultsOf 1903 participants, the median age was 53 (interquartile range [IQR], 46-62) years, and females accounted for 21.9%. Adjusted increased risk of mortality was linearly related to the decreasing lymphocyte percentage (P-non-linearity = 0.942) and increasing RDW (P-non-linearity = 0.612), and per standard deviation (SD) of increment lymphocyte percentage and RDW was associated with the 26% (0.74, 0.64-0.84) decrement and 5% (1.05, 0.95-1.15) increment in hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality, respectively. Importantly, lymphopenia and elevation of RDW exhibited a significant interaction with increasing the risk of AAD mortality (P-value for interaction = 0.037). ConclusionsLymphopenia accompanied by the elevation of RDW, which may reflect the immune dysregulation of AAD patients, is associated with an increased risk of mortality. Assessment of immunological biomarkers derived from routine tests may provide novel perspectives for identifying the risk of mortality."

基金机构：Chinese Society of Cardiology Foun-dation [CSCF2020B03]; [8187021109]; [8207021929]; [82100510]

基金资助正文：The authors thank Dr. Liangkai Chen for his assistance with the statistical analyses.