Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia · 2025
Predictive Value of Normalized Lactate Load for Patients with Acute Type A Aortic Dissection: Based on the MIMIC-IV Database.
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Zhang Qian, Jiang Jia
Аннотация
PURPOSE: The objective of this study was to examine the correlation between normalized lactate load (NLL) and the 30-day mortality rate in patients with acute type A aortic dissection (AAAD) patients, as well as its predictive value for prognosis.
METHODS: Data were obtained from the Medical Information Mart for Intensive Care-IV database. The Cox model and restricted cubic spline (RCS) were used to assess the relationship between NLL and 30-day mortality in AAAD patients. Receiver-operating characteristic curves were plotted to evaluate the predictive value of NLL for 7-, 14-, and 30-day mortality. Kaplan-Meier (K-M) curves were used to compare 30-day survival across different risk levels.
RESULTS: Among 150 AAAD patients, NLL was recognized as a risk factor for 30-day mortality (hazard ratio = 1.83, 95% confidence interval: 1.29-2.58; P <0.001). The RCS analysis showed a linear relationship. NLL showed areas under the curve of 0.781, 0.781, and 0.730 for predicting 7-, 14-, and 30-day mortality, respectively. K-M curves revealed a significant difference in 30-day survival between the high- and low-risk groups (log-rank P = 0.042).
CONCLUSION: NLL is a risk factor for 30-day mortality in AAAD patients and shows good predictive value. This study supports NLL as an early-warning biomarker for identifying high-risk AAAD patients.
METHODS: Data were obtained from the Medical Information Mart for Intensive Care-IV database. The Cox model and restricted cubic spline (RCS) were used to assess the relationship between NLL and 30-day mortality in AAAD patients. Receiver-operating characteristic curves were plotted to evaluate the predictive value of NLL for 7-, 14-, and 30-day mortality. Kaplan-Meier (K-M) curves were used to compare 30-day survival across different risk levels.
RESULTS: Among 150 AAAD patients, NLL was recognized as a risk factor for 30-day mortality (hazard ratio = 1.83, 95% confidence interval: 1.29-2.58; P <0.001). The RCS analysis showed a linear relationship. NLL showed areas under the curve of 0.781, 0.781, and 0.730 for predicting 7-, 14-, and 30-day mortality, respectively. K-M curves revealed a significant difference in 30-day survival between the high- and low-risk groups (log-rank P = 0.042).
CONCLUSION: NLL is a risk factor for 30-day mortality in AAAD patients and shows good predictive value. This study supports NLL as an early-warning biomarker for identifying high-risk AAAD patients.