{"title":"加入循环血浆白细胞介素-10可提高急性A型主动脉夹层手术死亡率的风险预测能力","authors":"Yi-Fei Diao, Zhi-Bin Chen, Jia-Xi Gu, Xin-Yang Xu, Wen-Feng Lin, Chun-Ze Yuan, Jia-Qi Xiong, Ming-Hui Li, Bu-Qing Ni, Sheng Zhao, Yong-Feng Shao, Ying-Yuan Zhang, Hong Liu","doi":"10.31083/RCM26334","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Acute type A aortic dissection (TAAD) is a life-threatening cardiovascular emergency with a high mortality rate. The peri-operative factors influencing in-hospital mortality among surgically treated TAAD patients remain unclear. This study aimed to identify key peri-operative risk factors associated with in-hospital mortality.</p><p><strong>Methods: </strong>Peri-operative laboratory data, surgical strategies, and TAAD-related risk factors, associated with mortality, were collected. Machine learning techniques were applied to evaluate the impact of various parameters on in-hospital mortality. Based on the findings, a nomogram model was developed and validated using area under the receiver operating characteristic curve (AUC) analysis, calibration plots, and internal validation methods.</p><p><strong>Results: </strong>A total of 199 patients with TAAD were included in the study cohort, which was divided into derivation and validation cohorts. Using the least absolute shrinkage and selection operator (LASSO) regression method, 66 features were narrowed down to six key predictors. These included age, lymphocyte count, use of continuous renal replacement therapy (CRRT), cardiopulmonary bypass (CPB) time, duration of mechanical ventilation, and postoperative interleukin-10 (IL-10) levels, all of which were identified as significant risk factors for in-hospital mortality following TAAD surgery.</p><p><strong>Conclusions: </strong>We developed and validated a predictive model, presented as a nomogram, to estimate in-hospital survival in patients with TAAD. Post-operative IL-10 was identified as an independent prognostic factor for patients with TAAD. The combination of IL-10 with five additional indicators significantly improved the predictive accuracy, demonstrating superiority over the use of any single variable alone.</p><p><strong>Clinical trial registration: </strong>This study protocol was registered at ClinicalTrials.gov (NCT04711889). https://clinicaltrials.gov/study/NCT04711889.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 2","pages":"26334"},"PeriodicalIF":1.9000,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868896/pdf/","citationCount":"0","resultStr":"{\"title\":\"Incorporating Circulating Plasma Interleukin-10 Enhanced Risk Predictability of Mortality in Acute Type A Aortic Dissection Surgery.\",\"authors\":\"Yi-Fei Diao, Zhi-Bin Chen, Jia-Xi Gu, Xin-Yang Xu, Wen-Feng Lin, Chun-Ze Yuan, Jia-Qi Xiong, Ming-Hui Li, Bu-Qing Ni, Sheng Zhao, Yong-Feng Shao, Ying-Yuan Zhang, Hong Liu\",\"doi\":\"10.31083/RCM26334\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Acute type A aortic dissection (TAAD) is a life-threatening cardiovascular emergency with a high mortality rate. The peri-operative factors influencing in-hospital mortality among surgically treated TAAD patients remain unclear. This study aimed to identify key peri-operative risk factors associated with in-hospital mortality.</p><p><strong>Methods: </strong>Peri-operative laboratory data, surgical strategies, and TAAD-related risk factors, associated with mortality, were collected. Machine learning techniques were applied to evaluate the impact of various parameters on in-hospital mortality. Based on the findings, a nomogram model was developed and validated using area under the receiver operating characteristic curve (AUC) analysis, calibration plots, and internal validation methods.</p><p><strong>Results: </strong>A total of 199 patients with TAAD were included in the study cohort, which was divided into derivation and validation cohorts. Using the least absolute shrinkage and selection operator (LASSO) regression method, 66 features were narrowed down to six key predictors. These included age, lymphocyte count, use of continuous renal replacement therapy (CRRT), cardiopulmonary bypass (CPB) time, duration of mechanical ventilation, and postoperative interleukin-10 (IL-10) levels, all of which were identified as significant risk factors for in-hospital mortality following TAAD surgery.</p><p><strong>Conclusions: </strong>We developed and validated a predictive model, presented as a nomogram, to estimate in-hospital survival in patients with TAAD. Post-operative IL-10 was identified as an independent prognostic factor for patients with TAAD. The combination of IL-10 with five additional indicators significantly improved the predictive accuracy, demonstrating superiority over the use of any single variable alone.</p><p><strong>Clinical trial registration: </strong>This study protocol was registered at ClinicalTrials.gov (NCT04711889). https://clinicaltrials.gov/study/NCT04711889.</p>\",\"PeriodicalId\":20989,\"journal\":{\"name\":\"Reviews in cardiovascular medicine\",\"volume\":\"26 2\",\"pages\":\"26334\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-02-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868896/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Reviews in cardiovascular medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.31083/RCM26334\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/2/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reviews in cardiovascular medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.31083/RCM26334","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Incorporating Circulating Plasma Interleukin-10 Enhanced Risk Predictability of Mortality in Acute Type A Aortic Dissection Surgery.
Background: Acute type A aortic dissection (TAAD) is a life-threatening cardiovascular emergency with a high mortality rate. The peri-operative factors influencing in-hospital mortality among surgically treated TAAD patients remain unclear. This study aimed to identify key peri-operative risk factors associated with in-hospital mortality.
Methods: Peri-operative laboratory data, surgical strategies, and TAAD-related risk factors, associated with mortality, were collected. Machine learning techniques were applied to evaluate the impact of various parameters on in-hospital mortality. Based on the findings, a nomogram model was developed and validated using area under the receiver operating characteristic curve (AUC) analysis, calibration plots, and internal validation methods.
Results: A total of 199 patients with TAAD were included in the study cohort, which was divided into derivation and validation cohorts. Using the least absolute shrinkage and selection operator (LASSO) regression method, 66 features were narrowed down to six key predictors. These included age, lymphocyte count, use of continuous renal replacement therapy (CRRT), cardiopulmonary bypass (CPB) time, duration of mechanical ventilation, and postoperative interleukin-10 (IL-10) levels, all of which were identified as significant risk factors for in-hospital mortality following TAAD surgery.
Conclusions: We developed and validated a predictive model, presented as a nomogram, to estimate in-hospital survival in patients with TAAD. Post-operative IL-10 was identified as an independent prognostic factor for patients with TAAD. The combination of IL-10 with five additional indicators significantly improved the predictive accuracy, demonstrating superiority over the use of any single variable alone.
Clinical trial registration: This study protocol was registered at ClinicalTrials.gov (NCT04711889). https://clinicaltrials.gov/study/NCT04711889.
期刊介绍：
RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.
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