LAUSR

We read with great interest the article “Association of Platelet to Lymphocyte and Neutrophil to Lymphocyte Ratios with InHospital Mortality in Patients with Type A Acute Aortic Dissection”, recently published in the Brazilian Journal of Cardiovascular Surgery[1]. This study included 96 type A acute aortic dissections (AAD) and indicated platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) as two novel indexes to predict in-hospital mortality. Type A AAD is a life-threatening disease, with a mortality of 50% in the first 48 hours, if not operated. Despite the progress in surgical techniques, in-hospital mortality can reach 25%[2]. It is known that the inflammation pathways involved in both Stanford type A and type B AAD and biomarkers based on inflammation could be potential risk stratification factors, including white blood cells, neutrophils and C-reactive protein. In the same way as the study by Selvi et al., our previous study also indicated that PLR was associated with in-hospital mortality in type B AAD[3]. However, there were no researches to compare the predictive values among the biomarkers. Therefore, we conducted a study to evaluate the predictive values of the biomarkers. In this retrospective study, we enrolled patients diagnosed with AAD by computed tomography angiography (CTA) between January 2013 and September 2015 at West China Hospital, Sichuan University. Patients were excluded if they had active or chronic inflammatory disease, hepatopathy or chronic kidney disease, known malignancy, and hypersplenism. For each patient, baseline clinical characteristics, biochemical and hematological values, and the medical history were obtained at admission. The study was approved by the local ethics committee and all patients gave informed consent. Categorical data were presented as frequencies and percentages, and continuous data were presented as mean and standard deviation (SD) or median and interquartile range. A receiver operating characteristic curve (ROC) analysis was performed to investigate the diagnostic performance. A P-value <0.05 was considered statistically significant. The demographic and clinical characteristics of the study population were presented in Table 1. A total of 833 patients with