Predictive value of systemic immune inflammation index combined with myoglobin in acute kidney injury after acute Stanford type A aortic dissection surgery
Objective To investigate the predictive value of systemic immune inflammation index(SII),myoglobin(Mb),and their combination for acute kidney injury(AKI)after acute Stanford type A aortic dissection(ATAAD)surgery.Methods A total of 102 patients with ATAAD who underwent surgical treatment in Henan Chest Hospital from February 2021 to December 2022 were selected as the research subjects.The patients were divided into the AKI group and the non-AKI group according to the occurrence of AKI or not after operation.The age,gender,smoking history,body mass index(BMI),hyperten-sion history,diabetes history,and hemoglobin,serum creatinine(Scr),blood urea nitrogen(BUN),uric acid(UA),myoglobin(Mb),SII and estimated glomerular filtration rate(eGFR)before operation,as well as operation time,cardiopulmonary bypass(CPB)time,aortic occlusion(ACC)time,intraoperative bleeding volume,and intraoperative urine volume were compared between the two groups.Univariate and multivariate logistic regression models were used to analyze the risk factors for AKI after ATAAD surgery,and receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of SII,Mb and their combination for AKI after ATAAD surgery.Results The overall incidence of AKI among 102 patients was 46.08％(47/102).There was no significant difference between the two groups in age,diabetes history,preoperative hemoglobin and BUN levels,ACC time,and intraoperative bleeding volume(P＞0.05),while gender,smoking history,BMI,hypertension history,preoperative SII,Mb,Scr,UA and eGFR,operation time,CPB time,and intraoperative urine volume had statistically significant differences between the two groups(P＜0.05).Multivariate logistic regression analysis showed that a history of hypertension,high BMI,preoperative high SII and Mb,and long CPB time were independent risk factors for AKI after ATAAD surgery(P＜0.05).ROC curve analysis showed that the cutoff values for predicting postoperative AKI in AT A AD patients with preoperative SII and Mb were 2 038.825 × 109 L-1 and 27.000 μg·L-1,respectively.The area under the curve(AUC)was 0.785 and 0.769,with a sensitivity of 0.745 and 0.766 and a specificity of 0.727 and 0.745,respectively.The ROC of combined preoperative SII and Mb for prediction of postoperative AKI in ATAAD patients was 0.800,sensitivity was 0.723,and specificity was 0.782.Conclusion A history of hypertension,high BMI,preoperative high SII and Mb levels,and long CPB time are independent risk factors for AKI after ATAAD surgery.Preoperative SII and Mb have certain values in predicting the occurrence of AKI after ATAAD surgery,and the predictive power of the combination is higher than that of a single indicator.
acute Stanford type A aortic dissectionacute kidney injurysystemic immune inflammation indexmyoglobin
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