Research On The Correlation Between Mean Platelet Volume To Platelet Count Ratio With Acute Aortic Dissection And Intramural Hematoma In-hospital Death Risk

ObjectiveTo collect complete medical records of patients diagnosed with acute aortic dissection(AAD)and aortic intermural hematoma(IMH)in our hospital,then statistically analyzed the relevant datas.The purpose of this research was to explore the predictive value of in-hospital mortality risk between Mean Platelet Volume(MPV)to Platelet Count(PC)Ratio(MPR)and AAD and IMH,which was expected to provide new treatment strategies for patients with AAD and IMH.MethodsAccording to the inclusion and exclusion criteria,a total of 172 patients with AAD and 66 patients with IMH were included in Zhujiang Hospital of Southern Medical University from May 2015 to December 2020.The basic clinical datas and auxiliary examination results of the patients were collected,and those patients were divided into the survival group and the death group according to the outcome at the time of discharge(patients who give up the treatment voluntarily were discharged into the death group).Statistical analysis was performed through applying SPSS 22.0,then to analyze whether MPR was an independent risk factor for in-hospital death of AAD and IMH patients through univariate analysis and multivariate logistic regression,and calculate odds ratio(OR)and 95%Confidence interval(95%CI),the ROC curve was used to explore the predictive value of MPR for the prognosis of patients with AAD and IMH and to determine the best cut-off point of MPR,patients were divided into high-MPR group and low-MPR group through basing on this cut-off point,compared the general clinical data of this two group,the Kaplan-Meier survival curve was used to calculate the cumulative survival rate of patients during hospitalization,and the general clinical datas of the AAD group and IMH group were compared.P<0.05 indicated that the difference was statistically significant.Results1.Age,diastolic blood pressure,white blood cell,neutrophil,platelet count,MPR,D-dimer,pericardial effusion,acute renal failure,the history of hypertension were risk factors for predicting in-hospital death in AAD patients.Logistic regression analysis showed that elevated MPR,leukocytosis,and ARF were independent risk factors for predicting hospital death in AAD patients.2.The ROC curve results of MPR for predicting in-hospital death of AAD patients showed that the AUC area was 61.30%,the best cut-off value was 0.058,the sensitivity was 55.60%,and the specificity was 67.70%(P=0.025).AAD patients were divided into high MPR group and low MPR group according to the best cut-off value,the proportion of in-hospital deaths and D-dimer of patients in the high MPR group were significantly higher than that of the low MPR group(P<0.05).3.MPR,D-dimer,pericardial effusion,maximum hematoma thickness and maximum aortic diameter,ulcer-like protrusion lesions were suspicious risk factors for in-hospital death of IMH patients.Logistic regression analysis showed that the above factors were not independent risk factors of in-hospital death of IMH patients.4.In the comparison between the AAD group and the IMH group,the MPR and D-dimer of the AAD group were higher than those of the IMH group,and the difference was statistically significant,MPR>0.050,acute renal failure,elevated D-dimer were helpful to assist the diagnosis of AAD,and when MPR<0.050,it was helpful to assist the diagnosis of IMH.5.The Kaplan-Meier survival curve showed that the survival rates of MPR≥0.058 and MPR<0.058 were statistically significant(P=0.015).Moreover,the difference in the survival rate of IMH patients with MPR≥0.076 and MPR<0.076 was significant(P=0.023).Conclusion1.MPR as an independent risk factor was positively correlated for in-hospital death in patients with AAD.the MPR of the death group was significantly higher than that of the survival group.2.MPR was not an independent risk factor for in-hospital death in patients with IMH.