D-Dimer/Platelet Ratio Predicts in-Hospital Death in Patients with Acute Type a Aortic Dissection

Purpose: Acute Type A aortic dissection (ATAAD) is a rare and life-threatening aortic disease. This study was aimed at the potential of the D-dimer to platelet count ratio (DPR) as a prognostic indicator of ATAAD.

Patients and methods: This study retrospectively analyzed ATAAD patients who were admitted to the Department of Cardiac Surgery, Fujian Medical University Union Hospital from January 2022 to April 2023. Patients were divided into survival (n = 173) and death (n = 24) groups based on whether death occurred. The primary outcome was death, and the secondary outcome was adverse hospitalization, including new postoperative arrhythmias, acute renal insufficiency, acute liver insufficiency, pleural effusion, length of ICU stay, mechanical ventilation length, and length of stay. The logistic regression model was used to analyze the relationship between DPR and in-hospital death, and the receiver operating characteristic curve (ROC) was drawn to analyze the predictive value of DPR for in-hospital death of ATAAD patients.

Results: Of the 197 patients included, 24 died, and the in-hospital mortality rate was 12.2%. There was a significant difference in diastolic blood pressure (P < 0.05). In terms of laboratory indexes, total bilirubin, direct bilirubin, indirect bilirubin, D-dimer, red blood cell volume distribution width, and DPR in the death group were higher than those in the survival group, with statistical significance (P < 0.05). Operation duration, hospital stay, ICU stay, mechanical ventilation time, and acute renal insufficiency in the death group were higher than those in the survival group (P < 0.05). Univariate analysis and multivariate analysis showed that DPR > 0.0305 ug/mL was an independent risk factor for death in ATAAD patients.

Conclusion: Increased DPR is independently associated with in-hospital death in patients with ATAAD.