Predictive Value of Normalized Lactate Load for Patients with Acute Type A Aortic Dissection: Based on the MIMIC-IV...

Area of Science:

• Cardiovascular Medicine
• Critical Care Medicine
• Biomarker Research

Background:

• Acute type A aortic dissection (AAAD) is a life-threatening condition with high mortality rates.
• Identifying reliable prognostic markers is crucial for timely intervention and improved patient outcomes.

Purpose of the Study:

• To investigate the association between normalized lactate load (NLL) and 30-day mortality in AAAD patients.
• To evaluate the predictive capability of NLL for short-term mortality in this patient cohort.

Main Methods:

• Utilized data from the Medical Information Mart for Intensive Care-IV database for 150 AAAD patients.
• Employed Cox regression and restricted cubic spline (RCS) analyses to assess the NLL-mortality relationship.
• Evaluated predictive performance using receiver-operating characteristic (ROC) curves and Kaplan-Meier (K-M) survival analysis.

Main Results:

• NLL was identified as an independent risk factor for 30-day mortality in AAAD patients (HR=1.83, P<0.001).
• RCS analysis indicated a linear relationship between NLL and mortality risk.
• NLL demonstrated good predictive value for 7-, 14-, and 30-day mortality (AUCs: 0.781, 0.781, 0.730).
• K-M curves showed significantly different 30-day survival rates between high- and low-NLL groups (P=0.042).

Conclusions:

• Normalized lactate load is a valuable prognostic biomarker in AAAD.
• NLL can serve as an early warning indicator for identifying high-risk AAAD patients.
• This finding supports the clinical utility of NLL in risk stratification and management of AAAD.