{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T22:19:28Z","timestamp":1780784368266,"version":"3.54.1"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100021171","name":"Basic and Applied Basic Research Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2025A1515012353"],"award-info":[{"award-number":["2025A1515012353"]}],"id":[{"id":"10.13039\/501100021171","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute aortic dissection (AD) and intramural hematoma (IMH) are associated with high mortality, necessitating reliable early risk prediction. The shock index (SI) is a potential prognostic marker in critical care, but its value in AD\/IMH remains unclear. This study evaluated the association between admission SI and in\u2010hospital all\u2010cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single\u2010center retrospective cohort study included 1250 patients with acute AD\/IMH, stratified by an optimal SI cut\u2010off of 0.6 determined by ROC analysis. Kaplan\u2010Meier curves and Cox proportional hazards models were used to assess the relationship. Subgroup analyses were also conducted to confirm the consistency of the main findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 30\u2010day cumulative in\u2010hospital all\u2010cause mortality was significantly higher in the SI\u2009\u2265\u20090.6 group than in the SI\u2009&lt;\u20090.6 group (Total: 25.7% vs. 14.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; Stanford A: 35.5% vs. 25.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; Stanford B: 13.4% vs. 4.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). An SI\u2009\u2265\u20090.6 was independently associated with increased in\u2010hospital mortality (adjusted hazard ratio (aHR) 1.67,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), consistent across Stanford A (aHR 1.52,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038) and Stanford B (aHR 2.57,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014) subgroups. Furthermore, the association was stronger among patients managed without surgery or thoracic endovascular aortic repair (TEVAR) (Total: aHR 2.02,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; Stanford A: aHR 1.77,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009; Stanford B: aHR 3.30,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>An admission SI\u2009\u2265\u20090.6 is independently associated with increased in\u2010hospital all\u2010cause mortality in acute AD\/IMH, particularly among those managed without surgery\/TEVAR. Admission SI may serve as a simple, rapid, and valuable tool for early clinical risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/clc.70333","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T11:45:49Z","timestamp":1777290349000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Admission Shock Index Is an Independent Predictor of In\u2010Hospital All\u2010Cause Mortality in Patients With Acute Aortic Dissection and Intramural Hematoma"],"prefix":"10.1002","volume":"49","author":[{"given":"Lingbin","family":"He","sequence":"first","affiliation":[{"name":"Department of Cardiology First Affiliated Hospital of Shantou University Medical College Shantou Guangdong China"},{"name":"Clinical Medical Research Center First Affiliated Hospital of Shantou University Medical College Shantou Guangdong China"},{"name":"Laboratory of Molecular Cardiology First Affiliated Hospital of Shantou University Medical College Shantou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yequn","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology First Affiliated Hospital of Shantou University Medical College Shantou Guangdong China"},{"name":"Clinical Medical Research Center First Affiliated Hospital of Shantou University Medical College Shantou Guangdong China"},{"name":"Human Phenome Institute of Shantou University Medical College, Guangdong Engineering Research Centre of Human Phenome Chemistry and Chemical Engineering Guangdong Laboratory Shantou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuihong","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Cardiology First Affiliated Hospital of Shantou University Medical College Shantou Guangdong China"},{"name":"Clinical Medical Research Center First Affiliated Hospital of Shantou University Medical College Shantou Guangdong China"},{"name":"Human Phenome Institute of Shantou University Medical College, Guangdong Engineering Research Centre of Human Phenome Chemistry and Chemical Engineering Guangdong Laboratory Shantou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junshuang","family":"Tang","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Shantou University Medical College Shantou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiwan","family":"Wu","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Shantou University Medical College Shantou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiongxia","family":"Xu","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Shantou University Medical College Shantou Guangdong 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5113-1420","authenticated-orcid":false,"given":"Xin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology First Affiliated Hospital of Shantou University Medical College Shantou Guangdong China"},{"name":"Clinical Medical Research Center First Affiliated Hospital of Shantou University Medical College Shantou Guangdong China"},{"name":"Laboratory of Molecular Cardiology First Affiliated Hospital of Shantou University Medical College Shantou Guangdong 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