Perioperative Eosinophils Their Recovery in Type A Acute Aortic Dissection Prognosis
Condition: Acute Aortic Dissection
MeSH terms: Aortic Dissection
Study type: Observational

Summary: 
      Type A acute aortic dissection (TA-AAD) patients are prone to life-threatening complications
      and death during the acute phase. Currently, little evidence is available with regards to the
      relationship between eosinophils (EOS) and TA-AAD.

      A total of 274 patients with TA-AAD were eligible for inclusion and 54 patients deceased
      within 1 month following surgery. Multivariate regression analysis, the general linear model
      repeated-measures ANOVA analysis (corrected by Greenhouse-Geisser test), receiver-operating
      characteristics (ROC) curves and a Kaplan-Meier curve were applied for statistical analysis.
    

Detailed description: 
      For this study, 274 patients with TA-AAD admitted into our hospital between February 2019 and
      July 2021 were enrolled retrospectively. A total of 54 patients deceased unfortunately within
      1 month following surgery. We compared baseline sociodemographic, clinical, and functional
      status based on the main outcome using t tests or Mann-Whitney U test for continuous data and
      χ2 or Fisher's exact tests for categorical data. Continuous variables were expressed as mean
      SD median depending on the normality of distribution, and categorical variables were
      expressed as absolute number along with their percentages and compared using the chi-square
      test. Multivariate regression analysis was applied to assess the association between EOS and
      1-month mortality in an unadjusted model, in an age-, sex-, Body mass index (BMI)-adjusted
      model (model 2), adjusted for age, sex, BMI, systolic blood pressure (SBP), diastolic blood
      pressure (DBP) and mean arterial pressure (MAP) (model 3), and further adjusting for age,
      sex, BMI, SBP, DBP, MAP, heart rate (HR), diabetes, stroke and hyperlipidemia (model 4). In
      addition, the general linear model repeated-measures ANOVA analysis (Corrected by
      Greenhouse-Geisser test in nonspherical cases) was used to compare preoperative EOS and
      postoperative eight-days EOS. For prognostic analysis, receiver-operating characteristics
      (ROC) curves were used to determine the optimal cutoff of EOS at different points and the
      time of postoperative EOS to return to normal levels for the prognostic events. A
      Kaplan-Meier curve was then applied to compare the prognosis between the 2 subgroups based on
      the predictive threshold. A P value<0.05 was regarded as statistically significant for all
      statistical tests.
    

Intervention name(s): This was a retrospective study with no intervention other than normal treatment
Intervention type(s): Other
Intervention description(s): This was a retrospective study with no intervention other than normal treatment
Observational model: Cohort
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        The patients were dignosed with Type A acute aortic dissection by the computer tomography
        between February 2019 and July 2021. A total of 54 patients deceased unfortunately within 1
        month following surgery. Depending on mortality within 1 month, the baseline
        characteristics was compared. Patients were 51.58±11.57 years of age, 203(74.1%) men, and
        161(58.8%) with hypertension. There was no discernible difference in gender, BMI, smoking,
        and alcohol consumption (P>0.05). Moreover, in addition to renal insufficiency, medical
        histories showed no remarkable deviations between the aforementioned two groups.
        Non-survivors within 1 month were more likely to have renal insufficiency (6.8% vs. 20.4%;
        P=0.005).
      
Keywords: Type A acute aortic dissection; Eosinophils; Prognosis