Serum uric acid tied to mortality risk in acute type A aortic dissection

There is a nonlinear relationship between serum uric acid levels upon admission and in-hospital mortality in patients with acute type A aortic dissection (ATAAD), a recent study has found.

The researchers conducted a retrospective observational analysis of 1,048 patients (mean age 50.17 years, 24.24 percent women) whose relevant clinical data, such as background sociodemographic characteristics, on-admission serum uric acid, lifestyle, and comorbidities, were collected from electronic medical records. The outcome of interest was in-hospital death.

Fully adjusted multivariate linear regression analysis showed that each 10-µmol/L increment in admission serum uric acid concentrations increased the likelihood of in-hospital mortality by 4 percent (odds ratio [OR], 1.04, 95 percent confidence interval [CI], 1.02–1.06).

A similar effect was reported when serum uric acid was taken as a categorical variable, though the researchers detected a potential nonlinear interaction with mortality risk, which was confirmed by subsequent linear regression modelling analyses.

The analysis found a premediated inflection point of 260 µmol/L. At or below this value, serum uric acid did not show any discernible impact on serum mortality. Above this threshold, however, 10-µmol/L increments led to a significant 4-percent excess in in-hospital death risk.

“These findings are believed to be the first to observe the threshold effect in the context of admission of in-hospital mortality and uric acid in patients with ATAAD,” the researchers said. “Furthermore, this study is expected to be a valuable reference point for prospective research regarding the formation of predictive and diagnostic models of in-hospital death rates in patients with ATAAD.”