Prognostic Value of the Preoperative Lymphocyte-to-Monocyte Ratio for Postoperative Adverse Events in Patients with Acute Type a Aortic Dissection.

Objective: To investigate the prognostic value of the preoperative lymphocyte-to-monocyte ratio (LMR) for postoperative adverse events in patients with acute type A aortic dissection (ATAAD).

Methods: A retrospective study of the clinical data collected in our hospital between March 2015 and January 2024 was performed on 290 patients diagnosed with ATAAD who underwent surgical treatment and met the inclusion criteria for patient selection. The included patients were divided into a low LMR group (<1.70, 50 cases) and a high LMR group (≥1.70, 51 cases). Clinical data, including white blood cell counts (WBCs), D-dimer (D-D) levels, lymphocyte count (LYM) and platelet count (PLT), were compared between the two groups. Logistic regression analysis assessed the association between the preoperative LMR and postoperative adverse events.

Results: The high LMR group had lower WBCs and NEU than the low LMR group (P < 0.05). The high LMR group also had higher LYM than the low LMR group (P < 0.05). Within 30 days postoperative, the all-cause mortality rate was higher in the low LMR group than in the high LMR group (P = 0.047). Within 1 year postoperative, the incidence of aortic adverse events (AAEs) (P = 0.010), Re-intervention events (P = 0.011) and Cardiovascular and cerebrovascular adverse events (P < 0.001) has no difference between the high LMR group and the low LMR group. Logistic regression analysis indicated that the preoperative LMR was a significant prognostic marker for AAEs within 30 days and 1 year postoperative.

Conclusion: The preoperative LMR is a prognostic indicator of all-cause mortality within 30 days and 1 year postoperative in patients with ATAAD.