Impact of admission serum total cholesterol level on in-hospital mortality in patients with acute aortic dissection

Objective: to find out the association between serum total cholesterol (tc) on admission and in-hospital mortality in patients with acute aortic dissection (aad). methods: from january 2007 to january 2014,we enrolled 1492 consecutive aad patients with serum tc measured immediately on admission. baseline characteristics and in-hospital mortality were compared between the patients with serum tc above and below the median (4.00 mmol/l). propensity score matching (psm) was used to account for known confounders in the study. cox proportional hazard model was performed to calculate the hazard ratio (hr) and 95% confidence interval (ci) for admission serum tc levels. results: with the use of psm,521 matched pairs of patients with aad were yielded in this analysis due to their similar propensity scores. patients with admission serum tc < 4.00 mmol/l,as compared with those with admission serum tc ≥ 4.00 mmol/l,had higher in-hospital mortality (11.7% vs. 5.8%; hr,2.06; 95% ci,1.33-3.19,p = 0.001). stratified analysis according to stanford classification showed that the inverse association between admission serum tc and in-hospital mortality was observed in patients with type-a aad (24.0% vs. 11.3%; hr,2.18; 95% ci,1.33 - 3.57,p = 0.002) but not in those with type-b aad (3.8% vs. 2.2%; hr,1.71; 95% ci,0.67 - 4.34,p = 0.261). conclusions: lower serum tc level on admission was strongly associated with higher in-hospital mortality in patients with type-a aad. © 2016,pakistan journal of medical sciences. all rights reserved.