Platelet Count To Lymphocyte Count Ratio May Predict Mortality In Stanford Type B Acute Aortic Dissection

Background: Acute aortic dissection (AAD) is a common disease with a high death rate. It has many relationships with inflammation activated by the tearing of the aortic wall. Our aim was to determine whether platelet-to-lymphocyte ratio (PLR) can predict the mortality of patients with Stanford type B AAD. Methods: We collected patients with Stanford type B AAD from 2007 to 2012. We measured the basic information for all patients such as race, sex, age, past medical history, white cell count, platelet count, lymphocyte count, treatment and so on. All of the patients were followed up for complications and survival status for years after admission. We used receiver-operating characteristic (ROC) analyses for end point events for all-cause mortality in order to determine the cut-off points. We divided the patients into high and low PLR groups. Logistic analysis and Kaplan-Meier curves were compared between the two groups. The relationship of the platelet count to lymphocyte count ratio and mortality was assessed for patients with Stanford type B AAD evaluate the prognosis of patients in these two groups by assessing the relationship of the PLR and mortality. Results: This study included 134 patients with Stanford type B AAD (men 73.9%). The study's primary end-point was all-cause death. The median time from symptom onset to the end of follow-up was 30.93 months. There were 19 deaths and 115 survivors. The best cut-off value was 260.68 (10(9)). The area under the curve was 0.711 (95% confidence interval 0.58-0.84. P < 0.05, sensitivity and specificity 63% and 88%). These patients were divided into high-PLR (n = 24) and low-PLR (n = 110) groups. The survival rate of low-PLR patients was significantly lower than that of the high-PLR group (58.3% vs 91.8%; P < 0.001). Correlation analyses and logistic analysis found that the following variables were independently associated with mortality: PLR (OR, 6.14; 95% CI, 1.401-26.895; P = 0.02). Conclusions: We found that the PLR was an independent risk factor for type B AAD and the PLR could be used to evaluate patient prognosis and assist physicians in selecting treatments.