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已发表论文
急性主动脉夹层患者术后院内死亡率的潜在预测指标 CALLY 指数的相关性研究
Authors Zhang H, Jiang F, Lin J, Yu X, Peng Y, Chen L, Lin Y
Received 11 July 2025
Accepted for publication 15 October 2025
Published 11 November 2025 Volume 2025:18 Pages 15833—15846
DOI https://doi.org/10.2147/JIR.S552987
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Qing Lin
Hailun Zhang,1,* Fei Jiang,2– 4,* Jingshan Lin,3 Xijing Yu,1 Yanchun Peng,2 Liangwan Chen,3,5 Yanjuan Lin2– 4
1School of Nursing, Fujian Medical University, Fuzhou, People’s Republic of China; 2Department of Nursing, Union Hospital, Fujian Medical University, Fuzhou, Gulou District, 350001, People’s Republic of China; 3Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350108, People’s Republic of China; 4Fujian Provincial Special Reserve Talents Laboratory, Fujian Medical University Union Hospital, Fuzhou, People’s Republic of China; 5Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fuzhou, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Liangwan Chen, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, Fujian, 350001, People’s Republic of China, Email fjxhlwc@163.com Yanjuan Lin, Department of Nursing, Union Hospital, Fujian Medical University, 29 Xinquan Road, Gulou District, Fuzhou, 350001, People’s Republic of China, Email fjxhyjl@163.com
Objective: Acute Type A Aortic Dissection (ATAAD) is a highly lethal cardiovascular emergency characterized by persistently high postoperative in-hospital mortality (POIM), which necessitates effective preoperative risk assessment tools. This study aimed to investigate the predictive value of the preoperative CRP-albumin-lymphocyte (CALLY) index for POIM in ATAAD patients and to construct a corresponding nomogram model.
Methods: This retrospective study enrolled 522 surgically treated ATAAD patients admitted to Fujian Medical University Union Hospital between October 2015 and July 2024, with POIM designated as the study endpoint. Univariate and multivariate logistic regression analyses were performed to identify predictors of POIM,and LASSO regression was subsequently used to develop a predictive model.
Results: This study included a total of 522 patients. The results demonstrated that the preoperative CALLY index was an independent protective factor for POIM (OR=0.131, 95% CI:0.110– 0.199), and its predictive performance (AUC=0.820) was superior to that of individual parameters such as lymphocyte count, albumin, and CRP. Patients with lower CALLY index had significantly higher incidences of postoperative gastrointestinal hemorrhage, acute kidney injury, and POIM (P< 0.05). The nomogram model integrating pre-hospital emergency care, prothrombin time, urea, creatine kinase, troponin I, lactate, and CALLY index showed good predictive performance (AUC=0.843). Internal and external validations yielded robust AUCs of 0.849 and 0.869, respectively, with Hosmer-Lemeshow tests confirming good fit (P> 0.05).Subgroup analysis revealed that the predictive value of the CALLY index was consistent across different clinical subgroups.
Conclusion: The preoperative CALLY index demonstrates significant predictive efficacy for POIM in ATAAD patients. The developed nomogram model, incorporating the CALLY index, provides a practical tool for optimizing perioperative decision-making.
Keywords: acute type A aortic dissection, CALLY index, clinical outcomes, predictive model, malnutrition, inflammation index
1School of Nursing, Fujian Medical University, Fuzhou, People’s Republic of China; 2Department of Nursing, Union Hospital, Fujian Medical University, Fuzhou, Gulou District, 350001, People’s Republic of China; 3Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350108, People’s Republic of China; 4Fujian Provincial Special Reserve Talents Laboratory, Fujian Medical University Union Hospital, Fuzhou, People’s Republic of China; 5Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fuzhou, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Liangwan Chen, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, Fujian, 350001, People’s Republic of China, Email fjxhlwc@163.com Yanjuan Lin, Department of Nursing, Union Hospital, Fujian Medical University, 29 Xinquan Road, Gulou District, Fuzhou, 350001, People’s Republic of China, Email fjxhyjl@163.com
Objective: Acute Type A Aortic Dissection (ATAAD) is a highly lethal cardiovascular emergency characterized by persistently high postoperative in-hospital mortality (POIM), which necessitates effective preoperative risk assessment tools. This study aimed to investigate the predictive value of the preoperative CRP-albumin-lymphocyte (CALLY) index for POIM in ATAAD patients and to construct a corresponding nomogram model.
Methods: This retrospective study enrolled 522 surgically treated ATAAD patients admitted to Fujian Medical University Union Hospital between October 2015 and July 2024, with POIM designated as the study endpoint. Univariate and multivariate logistic regression analyses were performed to identify predictors of POIM,and LASSO regression was subsequently used to develop a predictive model.
Results: This study included a total of 522 patients. The results demonstrated that the preoperative CALLY index was an independent protective factor for POIM (OR=0.131, 95% CI:0.110– 0.199), and its predictive performance (AUC=0.820) was superior to that of individual parameters such as lymphocyte count, albumin, and CRP. Patients with lower CALLY index had significantly higher incidences of postoperative gastrointestinal hemorrhage, acute kidney injury, and POIM (P< 0.05). The nomogram model integrating pre-hospital emergency care, prothrombin time, urea, creatine kinase, troponin I, lactate, and CALLY index showed good predictive performance (AUC=0.843). Internal and external validations yielded robust AUCs of 0.849 and 0.869, respectively, with Hosmer-Lemeshow tests confirming good fit (P> 0.05).Subgroup analysis revealed that the predictive value of the CALLY index was consistent across different clinical subgroups.
Conclusion: The preoperative CALLY index demonstrates significant predictive efficacy for POIM in ATAAD patients. The developed nomogram model, incorporating the CALLY index, provides a practical tool for optimizing perioperative decision-making.
Keywords: acute type A aortic dissection, CALLY index, clinical outcomes, predictive model, malnutrition, inflammation index