DAR was independently associated with postoperative mortality within 30 days in patients with AAAD (OR: 3.604, 95% CI: 1.495-8.685, p = 0.004) and shows good predictive performance (AUC: 0.710, 95% CI: 0.656-0.764).
The 30-day postoperative mortality rate among AAAD patients was 17.12%.
DAR was independently associated with 30-day postoperative mortality in AAAD patients on multivariate regression analysis.
DAR demonstrated good predictive performance for 30-day postoperative mortality in AAAD patients by receiver operating characteristic curve analysis.
Patients in the highest DAR group had the greatest number of adverse postoperative outcomes.
DAR is described as an emerging biomarker whose relationship with postoperative outcomes in AAAD had not previously been clearly established.
This research examined whether a simple ratio calculated from two common blood tests — D-dimer (a marker of blood clotting activity) divided by albumin (a protein reflecting nutritional status and inflammation) — could help predict which patients with a dangerous heart condition called acute type A aortic dissection (AAAD) were at higher risk of dying after emergency surgery. The study looked back at records from 619 patients treated at a Chinese hospital over approximately eight years. Among these patients, about 1 in 6 (17%) died within 30 days of surgery. The researchers found that patients with higher D-dimer to albumin ratio (DAR) values before surgery were significantly more likely to die within 30 days, to have heart-related complications, or to suffer strokes after their operation. Even after accounting for other health factors, a high DAR was associated with more than three times the odds of 30-day death compared to a lower DAR. The ratio also showed reasonably good ability to distinguish between patients who would and would not survive, with an area under the curve (AUC) of 0.71 — a statistical measure where 1.0 would be perfect prediction and 0.5 would be no better than chance. This research suggests that the DAR, which can be easily calculated from routine preoperative blood tests, may serve as a useful and accessible tool to help clinicians identify AAAD patients at higher risk for poor surgical outcomes. If confirmed by future prospective studies, this could assist in preoperative risk stratification and potentially guide more intensive monitoring or treatment decisions for higher-risk patients.
Lin A, Peng Y, Shao J, Chen L, Lin Y. (2026). Predictive Value of D-Dimer to Albumin Ratio for Outcome in Acute Type A Aortic Dissection Patients.. Journal of clinical hypertension (Greenwich, Conn.). https://doi.org/10.1111/jch.70339