D-二聚体对急性主动脉夹层患者住院死亡率预测价值的Meta分析

Meta-analysis of the predictive value of D-dimer for in-hospital mortality in patients with acute aortic dissection

目的分析D-二聚体水平与急性主动脉夹层(acute aortic dissection,AAD)住院死亡率的关系。方法系统性检索PubMed、Embase、Web of Science、维普、中国知网及中国学术期刊数据库等数据库关于D-二聚体水平与AAD住院死亡率的文献,搜索时间截止至2023年1月1日,行Meta分析D-二聚体水平与AAD住院死亡率的关系。结果共纳入18项研究4904例患者。Meta分析发现,D-二聚体与AAD住院死亡率存在相关性(OR=1.35,95%CI=1.19~1.53)。亚组分析中,D-二聚体截断值≥5.0μg/ml(OR=2.15,95%CI=1.57~2.95)、D-二聚体截断值<5.0μg/ml(OR=1.19,95%CI=0.97~1.45)和D-二聚体作为连续值(OR=1.12,95%CI=1.09~1.16)均与AAD住院死亡率有显著相关性;AAD患者中A型夹层比例>50%(OR=1.36,95%CI=1.18~1.57)和比例≤50%(OR=1.36,95%CI=1.18~1.57)亦均有显著的相关性。结论D-二聚体是AAD患者住院死亡率的显著且独立的预测因子。

Objective To analyze the relationship between D-dimer level and in-hospital mortality in patients of acute aortic dissection(AAD).Methods A systematic search was performed for literature on D-dimer levels and in-hospital mortality of AAD in databases such as PubMed,Embase,Web of Science,VIP database,CNKI,and Chinese academic journal databases.The search time was up to January 1,2023.Meta-analysis was performed to evaluate relationship between D-dimer level and in-hospital mortality.Results A total of 18 studies with 4904 patients were included.Meta-analysis found that D-dimer was correlated with in-hospital mortality of AAD(OR=1.35,95%CI=1.19-1.53).In subgroup analysis,D-dimer cut-off value≥5.0μg/ml(OR=2.15,95%CI=1.57-2.95),D-dimer cut-off value<5.0μg/ml(OR=1.19,95%CI=0.97-1.45)and D-dimer as a continuous value(OR=1.12,95%CI=1.09-1.16)were both significantly associated with in-hospital mortality of AAD.The proportion of type A dissection in AAD patients>50%(OR=1.36,95%CI=1.18-1.57)and proportion≤50%(OR=1.36,95%CI=1.18-1.57)also have significant correlation in D-dimer and in-hospital mortality of AAD.Conclusion D-dimer is a significant and independent predictor of in-hospital mortality of AAD patients.