Diagnostic value of combined detection of systemic immune-inflammation index and D-dimer in acute aortic dissection

CHEN Bin; LUO Cheng; HOU Jing-yuan; DENG Xun-wei

doi:10.13820/j.cnki.gdyx.20243007

Abstract：Objective To investigate the diagnostic value of systemic immune-inflammation index(SII)com-bined with D-dimer detection in acute aortic dissection(AAD).Methods As the research group,160 patients diag-nosed with AAD treated in Meizhou People's Hospital were recruited between January 2020 and January 2024;and 151 patients with acute myocardial infarction(AMI)as control group.Clinical data,laboratory test results,D-dimer and SII levels were collected and compared in both groups.The logistic regression analysis was conducted to analyze the risk fac-tors of AAD.The diagnostic accuracy of D-dimer and SII for AAD was determined using a receiver operating characteris-tic(ROC)curve.Hosmer-Lemeshow calibration curves and decision curve analysis(DCA)were used to evaluate cali-bration and clinical validity.Results Comparison of age,gender,smoking,and diabetes showed no statistically signifi-cant difference between the two groups(P＞0.05).In comparison to the AMI group,the AAD group exhibited signifi-cantly elevated serum levels of D-dimer and SII(P＜0.05).The logistic regression results showed that elevated D-di-mer and SII levels were independent risk factors for AAD.ROC curve analysis indicated that the area under the ROC curve(AUC)and 95％confidence interval of SII combined with D-dimer detection used to diagnose the presence of AAD was 0.888(0.852,0.924),with a sensitivity of 0.863,a specificity of 0.775(P＜0.001).Furthermore,the combined di-agnostic performance of both markers was found to be superior to that of either marker alone.The Hosmer-Lemeshow cal-ibration curve demonstrated a good fit(P=0.527).Decision curve analysis(DCA)indicated that the overall net benefit of combining D-dimer and SII for the diagnosis of AAD was higher than that of using either marker alone when the thresh-old probability ranged from 0.11 to 0.89.Conclusion D-dimer and SII hold significant clinical value and net benefit for the diagnosis of AAD,with the highest value observed in their combined diagnostic use.