Association of lymphopenia and RDW elevation with risk of mortality in acute aortic dissection
The study aimed to investigate whether lymphopenia and red blood cell distribution width (RDW) elevation are associated with an increased risk of mortality in acute aortic dissection (AAD). This multicenter retrospective cohort study enrolled patients diagnosed with AAD by aortic computed tomographi...
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| Veröffentlicht in: | PloS one 2023-03, Vol.18 (3), p.e0283008-e0283008 |
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| creator | Yu, Dan Chen, Peng Zhang, Xueyan Wang, Hongjie Dhuromsingh, Menaka Wu, Jinxiu Qin, Bingyu Guo, Suping Zhang, Baoquan Li, Chunwen Zeng, Hesong |
| description | The study aimed to investigate whether lymphopenia and red blood cell distribution width (RDW) elevation are associated with an increased risk of mortality in acute aortic dissection (AAD).
This multicenter retrospective cohort study enrolled patients diagnosed with AAD by aortic computed tomographic angiography (CTA) from 2010 to 2021 in five teaching hospitals in central-western China. Cox proportional hazards regression and Kaplan-Meier curves were used in univariable and multivariable models. Clinical outcomes were defined as all-cause in-hospital mortality, while associations were evaluated between lymphopenia, accompanied by an elevated RDW, and risk of mortality.
Of 1903 participants, the median age was 53 (interquartile range [IQR], 46-62) years, and females accounted for 21.9%. Adjusted increased risk of mortality was linearly related to the decreasing lymphocyte percentage (P-non-linearity = 0.942) and increasing RDW (P-non-linearity = 0.612), and per standard deviation (SD) of increment lymphocyte percentage and RDW was associated with the 26% (0.74, 0.64-0.84) decrement and 5% (1.05, 0.95-1.15) increment in hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality, respectively. Importantly, lymphopenia and elevation of RDW exhibited a significant interaction with increasing the risk of AAD mortality (P-value for interaction = 0.037).
Lymphopenia accompanied by the elevation of RDW, which may reflect the immune dysregulation of AAD patients, is associated with an increased risk of mortality. Assessment of immunological biomarkers derived from routine tests may provide novel perspectives for identifying the risk of mortality. |
| doi_str_mv | 10.1371/journal.pone.0283008 |
| format | Article |
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This multicenter retrospective cohort study enrolled patients diagnosed with AAD by aortic computed tomographic angiography (CTA) from 2010 to 2021 in five teaching hospitals in central-western China. Cox proportional hazards regression and Kaplan-Meier curves were used in univariable and multivariable models. Clinical outcomes were defined as all-cause in-hospital mortality, while associations were evaluated between lymphopenia, accompanied by an elevated RDW, and risk of mortality.
Of 1903 participants, the median age was 53 (interquartile range [IQR], 46-62) years, and females accounted for 21.9%. Adjusted increased risk of mortality was linearly related to the decreasing lymphocyte percentage (P-non-linearity = 0.942) and increasing RDW (P-non-linearity = 0.612), and per standard deviation (SD) of increment lymphocyte percentage and RDW was associated with the 26% (0.74, 0.64-0.84) decrement and 5% (1.05, 0.95-1.15) increment in hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality, respectively. Importantly, lymphopenia and elevation of RDW exhibited a significant interaction with increasing the risk of AAD mortality (P-value for interaction = 0.037).
Lymphopenia accompanied by the elevation of RDW, which may reflect the immune dysregulation of AAD patients, is associated with an increased risk of mortality. Assessment of immunological biomarkers derived from routine tests may provide novel perspectives for identifying the risk of mortality.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0283008</identifier><identifier>PMID: 36920980</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Angiography ; Aorta ; Aortic Dissection ; Biology and Life Sciences ; Biomarkers ; Blood tests ; Bone Marrow Diseases ; Computed tomography ; Confidence intervals ; Congenital diseases ; Coronary vessels ; Data collection ; Development and progression ; Diabetes ; Dissecting aneurysm ; Dissection ; Electronic health records ; Erythrocyte Indices ; Erythrocytes ; Female ; Health hazards ; Health risks ; Hematoma ; Hospitals ; Humans ; Hypertension ; Immunology ; Infectious diseases ; Inflammation ; Lymphocytes ; Lymphocytopenia ; Lymphopenia ; Medical imaging ; Medical records ; Medicine and Health Sciences ; Methods ; Middle Aged ; Mortality ; Mortality risk ; Nonlinearity ; Patient outcomes ; Patients ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Software ; Statistical analysis ; Trauma ; Vital signs</subject><ispartof>PloS one, 2023-03, Vol.18 (3), p.e0283008-e0283008</ispartof><rights>Copyright: © 2023 Yu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2023 Public Library of Science</rights><rights>2023 Yu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 Yu et al 2023 Yu et al</rights><rights>2023 Yu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c642t-ee48ecf2780ab776038a91fa43d7f294d1ec0de4d4631c903c4835ddeb50cc8a3</cites><orcidid>0000-0003-0514-003X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10016706/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10016706/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36920980$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Aktas, Gulali</contributor><creatorcontrib>Yu, Dan</creatorcontrib><creatorcontrib>Chen, Peng</creatorcontrib><creatorcontrib>Zhang, Xueyan</creatorcontrib><creatorcontrib>Wang, Hongjie</creatorcontrib><creatorcontrib>Dhuromsingh, Menaka</creatorcontrib><creatorcontrib>Wu, Jinxiu</creatorcontrib><creatorcontrib>Qin, Bingyu</creatorcontrib><creatorcontrib>Guo, Suping</creatorcontrib><creatorcontrib>Zhang, Baoquan</creatorcontrib><creatorcontrib>Li, Chunwen</creatorcontrib><creatorcontrib>Zeng, Hesong</creatorcontrib><title>Association of lymphopenia and RDW elevation with risk of mortality in acute aortic dissection</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The study aimed to investigate whether lymphopenia and red blood cell distribution width (RDW) elevation are associated with an increased risk of mortality in acute aortic dissection (AAD).
This multicenter retrospective cohort study enrolled patients diagnosed with AAD by aortic computed tomographic angiography (CTA) from 2010 to 2021 in five teaching hospitals in central-western China. Cox proportional hazards regression and Kaplan-Meier curves were used in univariable and multivariable models. Clinical outcomes were defined as all-cause in-hospital mortality, while associations were evaluated between lymphopenia, accompanied by an elevated RDW, and risk of mortality.
Of 1903 participants, the median age was 53 (interquartile range [IQR], 46-62) years, and females accounted for 21.9%. Adjusted increased risk of mortality was linearly related to the decreasing lymphocyte percentage (P-non-linearity = 0.942) and increasing RDW (P-non-linearity = 0.612), and per standard deviation (SD) of increment lymphocyte percentage and RDW was associated with the 26% (0.74, 0.64-0.84) decrement and 5% (1.05, 0.95-1.15) increment in hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality, respectively. Importantly, lymphopenia and elevation of RDW exhibited a significant interaction with increasing the risk of AAD mortality (P-value for interaction = 0.037).
Lymphopenia accompanied by the elevation of RDW, which may reflect the immune dysregulation of AAD patients, is associated with an increased risk of mortality. Assessment of immunological biomarkers derived from routine tests may provide novel perspectives for identifying the risk of mortality.</description><subject>Analysis</subject><subject>Angiography</subject><subject>Aorta</subject><subject>Aortic Dissection</subject><subject>Biology and Life Sciences</subject><subject>Biomarkers</subject><subject>Blood tests</subject><subject>Bone Marrow Diseases</subject><subject>Computed tomography</subject><subject>Confidence intervals</subject><subject>Congenital diseases</subject><subject>Coronary vessels</subject><subject>Data collection</subject><subject>Development and progression</subject><subject>Diabetes</subject><subject>Dissecting aneurysm</subject><subject>Dissection</subject><subject>Electronic health records</subject><subject>Erythrocyte Indices</subject><subject>Erythrocytes</subject><subject>Female</subject><subject>Health hazards</subject><subject>Health risks</subject><subject>Hematoma</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Immunology</subject><subject>Infectious diseases</subject><subject>Inflammation</subject><subject>Lymphocytes</subject><subject>Lymphocytopenia</subject><subject>Lymphopenia</subject><subject>Medical imaging</subject><subject>Medical records</subject><subject>Medicine and Health Sciences</subject><subject>Methods</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Mortality risk</subject><subject>Nonlinearity</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Software</subject><subject>Statistical analysis</subject><subject>Trauma</subject><subject>Vital 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of lymphopenia and RDW elevation with risk of mortality in acute aortic dissection</title><author>Yu, Dan ; Chen, Peng ; Zhang, Xueyan ; Wang, Hongjie ; Dhuromsingh, Menaka ; Wu, Jinxiu ; Qin, Bingyu ; Guo, Suping ; Zhang, Baoquan ; Li, Chunwen ; Zeng, Hesong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c642t-ee48ecf2780ab776038a91fa43d7f294d1ec0de4d4631c903c4835ddeb50cc8a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Analysis</topic><topic>Angiography</topic><topic>Aorta</topic><topic>Aortic Dissection</topic><topic>Biology and Life Sciences</topic><topic>Biomarkers</topic><topic>Blood tests</topic><topic>Bone Marrow Diseases</topic><topic>Computed tomography</topic><topic>Confidence intervals</topic><topic>Congenital diseases</topic><topic>Coronary vessels</topic><topic>Data collection</topic><topic>Development and 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One</addtitle><date>2023-03-15</date><risdate>2023</risdate><volume>18</volume><issue>3</issue><spage>e0283008</spage><epage>e0283008</epage><pages>e0283008-e0283008</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The study aimed to investigate whether lymphopenia and red blood cell distribution width (RDW) elevation are associated with an increased risk of mortality in acute aortic dissection (AAD).
This multicenter retrospective cohort study enrolled patients diagnosed with AAD by aortic computed tomographic angiography (CTA) from 2010 to 2021 in five teaching hospitals in central-western China. Cox proportional hazards regression and Kaplan-Meier curves were used in univariable and multivariable models. Clinical outcomes were defined as all-cause in-hospital mortality, while associations were evaluated between lymphopenia, accompanied by an elevated RDW, and risk of mortality.
Of 1903 participants, the median age was 53 (interquartile range [IQR], 46-62) years, and females accounted for 21.9%. Adjusted increased risk of mortality was linearly related to the decreasing lymphocyte percentage (P-non-linearity = 0.942) and increasing RDW (P-non-linearity = 0.612), and per standard deviation (SD) of increment lymphocyte percentage and RDW was associated with the 26% (0.74, 0.64-0.84) decrement and 5% (1.05, 0.95-1.15) increment in hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality, respectively. Importantly, lymphopenia and elevation of RDW exhibited a significant interaction with increasing the risk of AAD mortality (P-value for interaction = 0.037).
Lymphopenia accompanied by the elevation of RDW, which may reflect the immune dysregulation of AAD patients, is associated with an increased risk of mortality. Assessment of immunological biomarkers derived from routine tests may provide novel perspectives for identifying the risk of mortality.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>36920980</pmid><doi>10.1371/journal.pone.0283008</doi><orcidid>https://orcid.org/0000-0003-0514-003X</orcidid><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_2787181115 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Analysis Angiography Aorta Aortic Dissection Biology and Life Sciences Biomarkers Blood tests Bone Marrow Diseases Computed tomography Confidence intervals Congenital diseases Coronary vessels Data collection Development and progression Diabetes Dissecting aneurysm Dissection Electronic health records Erythrocyte Indices Erythrocytes Female Health hazards Health risks Hematoma Hospitals Humans Hypertension Immunology Infectious diseases Inflammation Lymphocytes Lymphocytopenia Lymphopenia Medical imaging Medical records Medicine and Health Sciences Methods Middle Aged Mortality Mortality risk Nonlinearity Patient outcomes Patients Prognosis Proportional Hazards Models Retrospective Studies Risk Factors Software Statistical analysis Trauma Vital signs |
| title | Association of lymphopenia and RDW elevation with risk of mortality in acute aortic dissection |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-18T12%3A00%3A24IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Association%20of%20lymphopenia%20and%20RDW%20elevation%20with%20risk%20of%20mortality%20in%20acute%20aortic%20dissection&rft.jtitle=PloS%20one&rft.au=Yu,%20Dan&rft.date=2023-03-15&rft.volume=18&rft.issue=3&rft.spage=e0283008&rft.epage=e0283008&rft.pages=e0283008-e0283008&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0283008&rft_dat=%3Cgale_plos_%3EA741362583%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2787181115&rft_id=info:pmid/36920980&rft_galeid=A741362583&rft_doaj_id=oai_doaj_org_article_0ca19fedb5454834adf657036bd0241d&rfr_iscdi=true |