Neutrophil percentage-to-albumin ratio is associated with in-hospital mortality in patients with acute aortic dissection: a multicenter retrospective cohort study.
9 affiliations
- 1Division of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 430030, China.
- 2Hubei Provincial Engineering Research Center of Vascular Interventional Therapy, Wuhan, 430030, China.
- 3Department of Cardiac Intensive Care Unit, Fuwai Central China Cardiovascular Hospital, Zhengzhou, 451460, China.
- 4Department of Critical Care Medicine, The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453700, China.
- 5Department of Emergency Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
- 6Department of Cardiology, Tongji Xianning Hospital, Xianning, 437011, China.
- 7Department of Cardiac Intensive Care Unit, Henan Provincial People's Hospital, No. 7 Weiwu Road, Zhengzhou, 450003, China. [email protected].
- 8Division of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 430030, China. [email protected].
- 9Hubei Provincial Engineering Research Center of Vascular Interventional Therapy, Wuhan, 430030, China. [email protected].
Abstract
Background
Early risk stratification remains challenging in patients with acute aortic dissection (AAD). This study aims to evaluate the prognostic value of neutrophil percentage-to-albumin ratio (NPAR) for in-hospital mortality in patients with acute aortic dissection.Methods
We performed a multicenter retrospective cohort study including 2,596 patients with AAD from five tertiary hospitals in China between 2010 and 2021. NPAR was calculated as neutrophil percentage divided by serum albumin concentration at admission. Patients were categorized into tertiles according to NPAR levels. The primary outcome was all-cause in-hospital mortality. Cox proportional hazards models were applied to assess the association between NPAR and mortality, adjusting for demographic and clinical confounders. Discriminative performance was evaluated using receiver operating characteristic (ROC) analysis.Results
A total of 576 patients (22.2%) died during hospitalization. Higher NPAR levels were independently associated with an increased risk of in-hospital mortality (adjusted hazard ratio per 10-unit increase = 1.71, 95% confidence interval 1.40-2.09, P < 0.001). Compared with the lowest tertile, patients in the highest tertile (≥ 22.6) also had a higher risk of death (HR = 1.56, 95% CI 1.25-1.94, P < 0.001). Restricted cubic spline analysis suggested a linear association between NPAR and mortality risk. NPAR showed a statistically significant but modest improvement in discrimination compared with neutrophil percentage (AUC 0.62 vs. 0.59, P = 0.006) and albumin (0.62 vs. 0.57, P < 0.001).Conclusions
Elevated NPAR is independently associated with higher in-hospital mortality in patients with acute aortic dissection. As an easily obtainable marker reflecting both inflammatory status and nutritional condition, NPAR may provide supplementary prognostic information for risk stratification. However, its discriminatory ability is modest, and it should be considered as an adjunct to established clinical risk factors rather than a standalone tool for clinical decision-making.
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BibTeX
@article{wusimanjiang2026neutrophil,
title = {{Neutrophil percentage-to-albumin ratio is associated with in-hospital mortality in patients with acute aortic dissection: a multicenter retrospective cohort study.}},
author = {Aizimaitijiang Wusimanjiang and Abudunaibi Balati and Wenhua Wang and Baoquan Zhang and Chunwen Li and Suping Guo and Xingwei He and Hongjie Wang and Dan Yu and Hesong Zeng},
journal = {BMC cardiovascular disorders},
year = {2026},
month = aug,
doi = {10.1186/s12872-026-06258-x},
url = {https://europepmc.org/article/MED/42958054},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Neutrophil percentage-to-albumin ratio is associated with in-hospital mortality in patients with acute aortic dissection: a multicenter retrospective cohort study.
AU - Aizimaitijiang Wusimanjiang
AU - Abudunaibi Balati
AU - Wenhua Wang
AU - Baoquan Zhang
AU - Chunwen Li
AU - Suping Guo
AU - Xingwei He
AU - Hongjie Wang
AU - Dan Yu
AU - Hesong Zeng
PY - 2026
DA - 2026/08/03
JO - BMC cardiovascular disorders
DO - 10.1186/s12872-026-06258-x
UR - https://europepmc.org/article/MED/42958054
AB - Background Early risk stratification remains challenging in patients with acute aortic dissection (AAD). This study aims to evaluate the prognostic value of neutrophil percentage-to-albumin ratio (NPAR) for in-hospital mortality in patients with acute aortic dissection.Methods We performed a multicenter retrospective cohort study including 2,596 patients with AAD from five tertiary hospitals in China between 2010 and 2021. NPAR was calculated as neutrophil percentage divided by serum albumin concentration at admission. Patients were categorized into tertiles according to NPAR levels. The primary outcome was all-cause in-hospital mortality. Cox proportional hazards models were applied to assess the association between NPAR and mortality, adjusting for demographic and clinical confounders. Discriminative performance was evaluated using receiver operating characteristic (ROC) analysis.Results A total of 576 patients (22.2%) died during hospitalization. Higher NPAR levels were independently associated with an increased risk of in-hospital mortality (adjusted hazard ratio per 10-unit increase = 1.71, 95% confidence interval 1.40-2.09, P < 0.001). Compared with the lowest tertile, patients in the highest tertile (≥ 22.6) also had a higher risk of death (HR = 1.56, 95% CI 1.25-1.94, P < 0.001). Restricted cubic spline analysis suggested a linear association between NPAR and mortality risk. NPAR showed a statistically significant but modest improvement in discrimination compared with neutrophil percentage (AUC 0.62 vs. 0.59, P = 0.006) and albumin (0.62 vs. 0.57, P < 0.001).Conclusions Elevated NPAR is independently associated with higher in-hospital mortality in patients with acute aortic dissection. As an easily obtainable marker reflecting both inflammatory status and nutritional condition, NPAR may provide supplementary prognostic information for risk stratification. However, its discriminatory ability is modest, and it should be considered as an adjunct to established clinical risk factors rather than a standalone tool for clinical decision-making.
SN - 1471-2261
ER -