Investigating the usefulness of platelet lymphocyte ratio (PLR) and neutrophil lymphocyte ratio (NLR) in predicting mortality in patients with aortic dissection

Objective: Aortic dissection (AD) is a life-threatening condition characterized by separation of the layers within the aortic wall. AD is the most common pathology among aortic emergencies. In this study, we aimed to investigate the effects of low-cost, easily accessible laboratory tests on the mortality of patients diagnosed with AD. Materials and Methods: In this study, demographic data, comorbid diseases, risk factors, blood parameters and mortality rates of 37 patients who were admitted to the Emergency Department of Ahi Evran University Faculty of Medicine Kırşehir Training and Research Hospital between 01/01/2013-01/01/2023 and diagnosed with AD and 40 control group patients with similar comorbid diseases and demographic characteristics were retrospectively analyzed. Results: In our study, 62.1% of AD patients were male and 37.2% were female. The mean age of AD patients was 62.57 11.55 years, the mean age of women was 69.07 8.0 years and the mean age of men was 57.95 11.96 years (p=0.004). Among AD patients, 23(62.1%) had hypertension(HT), 10(27%) had hyperlipidemia, 6(16.2%) had cardiovascular disease(CVD), 5(13.5%) had cerebrovascular disease, and 5(13.5%) had diabetes mellitus(DM). Platelet values of the control group (271.52 74.02) were higher than the platelet values of the patients in the intervention group (223.75 78.23) (p=0.007). Neutrophil values of the control group (5.01(2.97-9.97)) were lower than the platelet values of the patients in the treatment group (6.68(2.81-25.07))(p=0.014). Neutrophil to lymphocyte ratio(NLR) values of the control group (2.27(0.72-5.57)) were lower than NLR values of the intervention group (3.15(1.07-14.46))(p=0.038). The mean age of patients with in-hospital ex (67.86 10.65) was higher than the mean age of patients without in-hospital ex (58.27 11.23)(p=0.013). Of the patients who died in-hospital, 80% had type A dissection and 20.0% had type B dissection; mortality increased in type A dissection compared to type B (p=0.009). Of the patients who died in-hospital, 53.3% were type 1, 26.7% type 2 and 20.0% type 3 dissections; mortality increased in type 1 and type 2 dissections compared to type 3 (p=0.027). A 1-unit increase in the age of the patients increases the risk of in-hospital death by 1.104 times(OR: 1.104, 95%C.I.: 1.010-1.207, p=0.030). The presence of CVD increases the risk of in-hospital death by 10.50 times (OR: 10.50, 95% C.I.:1.079-102.17, p=0.043). Stanford type A dissection increases the risk of in-hospital death by 7.0 times (OR: 7.00, 95% C.I.:1.509-32.478, p=0.013). Having Debakey type 1 dissection increases the risk of in-hospital death by 9.199 times (OR: 9.199, 95% C.I.: 1.377-61.460, p=0.022). Having Debakey type 2 dissection increases the risk of in-hospital death by 7.914 times (OR: 7.914, 95% C.I.: 0.702-89.209, p=0.028). Conclusion: In this study, we found that the age of onset of AD was higher in women than in men, platelet count decreased while neutrophil count and neutrophil lymphocyte ratio (NLR) increased in patients with AD, mortality increased in Stanford type A dissection and DeBakey type 1 and type 2 dissections, advanced age and having cardiovascular disease (CVD) increased mortality, while platelet lymphocyte ratio (PLR) and NLR were not associated with mortality. We think that multicenter studies including large case series are needed in this regard. Keywords: Aortic dissection, PLR, NLR, Mortality