Predictive Value of D-Dimer to Albumin Ratio for Outcome in Acute Type A Aortic Dissection Patients

Preoperative risk assessment and identification of potential biomarkers may optimize prognostic outcomes in patients with aortic dissection patients. The relationship between the D-dimer to albumin ratio (DAR), an emerging biomarker that has recently attracted increasing attention, and postoperative outcomes in patients with acute type A aortic dissection (AAAD) remains unclear. Therefore, this study seeks to validate the correlation between DAR and adverse outcomes after surgery in this population and to provide a reliable reference for postoperative risk assessment in clinical AAAD. Patients with AAAD treated at Fujian Medical University Union Hospital between July 2013 and December 2021 were admitted in this cross-sectional retrospective study. To examine the link between DAR and poor prognosis in AAAD patients, logistic regression analysis was performed. The predictive capacity of the DAR was assessed through the receiver operating characteristic curve analysis. The entirety of 619 individuals were ultimately included, with 106 (17.12%) patients died within 30 days of surgery. The group with the highest DAR levels had the highest number of adverse outcomes, including postoperative mortality, adverse cardiovascular, and cerebrovascular events. DAR was independently associated with postoperative mortality within 30 days in patients with AAAD, as determined by multivariate regression analysis (OR: 3.604, 95% CI: 1.495-8.685, p = 0.004). DAR shows good predictive performance for postoperative mortality within 30 days in AAAD patients (AUC: 0.710, 95% CI: 0.656-0.764, P < 0.001). These findings suggest that DAR is significantly associated with 30-day postoperative mortality in patients with AAAD and has good predictive value.