Correlation Study Of Preoperative SII And SIRI With Short-term Prognosis In Type A Aortic Dissection Patients Undergoing Surgery

Objective:Aortic dissection(AD)is a dangerous cardiovascular disease with high mortality and fatal complications,and inflammation is an important hallmark of its occurrence and development.The exploration of inflammatory biomarkers associated with AD to aid its clinical application,differential diagnosis,prognosis assessment,and risk stratification has been a hotspot and challenge in current research.Currently,some simple and easily available inflammatory biomarkers show promise in these areas.Systemic Immune-inflammation Index(SII)and Systemic Inflammatory Response Index(SIRI)are inflammatory indicators composed of whole blood cells,and their roles have been proven in cardiovascular diseases,but been poorly reported in AD.The main purpose of this study is to investigate the value of SII and SIRI in the short-term prognosis of patients with type A aortic dissection(TAAD)undergoing surgery.Methods:According to the inclusion and exclusion criteria,A total of 67 patients who underwent type A aortic dissection in the Department of cardiac macrovascular Surgery of our hospital from January 2021 to December 2022 were retrospectively analyzed.Patients were divided into two groups based on postoperative 30-day clinical outcomes(survival and death).The relevant perioperative data were collected,including general data,laboratory data,surgical data,prognostic date,etc.The receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive ability of SII and SIRI on postoperative mortality of TAAD,and patients were divided into high SII group and low SII group,high SIRI group and low SIRI group according to the optimal cut-off value.The univariate and multivariate Logistic regression analysis were used to determine whether SII and SIRI were independent risk factors for short-term prognosis in patients with TAAD.Results:A total of 67 patients were included in this study,of which 48 survived and 19 died.The levels of leukocytes,neutrophils,SII and SIRI in death group were significantly higher than those in survival group(P < 0.05),but the levels of lymphocytes was significantly lower than that in survival group(P < 0.05).SII and SIRI were better than NLR and PLR in predicting postoperative mortality.The optimal cut-off value of SII was 1310.60,sensitivity 89.5%,specificity 58.3%(AUC:0.751,P < 0.05),and the optimal cut-off value of SIRI was 5.90,sensitivity 84.2%,specificity 56.2%(AUC:0.735,P < 0.05).The multivariate Logistic regression analysis showed that high preoperative SII,but not high preoperative SIRI,was an independent risk factor for 30-day postoperative mortality for TAAD(OR :11.373,95%CI :1.110-116.563,P=0.041).In addition,the incidence of acute hepatic and renal dysfunction was higher in high SII and high SIRI groups(P < 0.05).Conclusions:Inflammation is closely related to the prognosis of AD.Preoperative simple and easily accessible inflammatory biomarkers can provide additional prognostic and risk stratification information for TAAD patients.High preoperative SII,but not high SIRI,was an independent risk factor for short-term postoperative mortality in patients with TAAD.