A novel simplified thrombo-inflammatory prognostic score for predicting in-hospital complications and long-term mortality in patients with type A acute aortic dissection: a prospective cohort study

Inflammation and thrombosis are involved in the progression of acute aortic dissection (AD). A novel simplified thrombo-inflammatory prognostic score (sTIPS), based on white blood cell count (WBC) and mean platelet volume (MPV) to platelet count (PC) ratio (MPV/PC ratio), was assessed for its ability to predict adverse clinical outcomes in type A acute aortic dissection (AAD). One hundred and six patients with newly diagnosed AAD were included in the study. Simplified thrombo-inflammatory prognostic scores ranged from 0 to 2. Kaplan–Meier curves and multivariable Cox regression analyses were used to investigate the associations between sTIPS and adverse outcomes. Of 106 AAD patients, 71 (67.0%) died during the study period, with a median follow-up duration of 570 days. Compared with those with low sTIPS, patients with higher sTIPS had higher rates of in-hospital complications (all P< 0.05). In multivariable Cox regression models adjusted for potential confounders, sTIPS was positively associated with the hazard of all-cause mortality. For those with sTIPS scores of 0, 1, and 2, the multivariable-adjusted hazard ratios (95% confidence intervals) for mortality were 1.0 (ref.), 2.28 (1.23–4.21) (P = 0.008), and 5.26 (1.93–9.40) (P< 0.001), respectively. Subgroup analysis showed sTIPS was also positively associated with the hazard of all-cause mortality in patients with either medication only or urgent surgery. Simplified thrombo-inflammatory prognostic score, a combined inflammatory-thrombotic score, was a strong independent predictor for long-term adverse outcomes in patients with AAD.