Use of Neutrophils may enhance early diagnostic accuracy in identifying ruptured abdominal aortic aneurysms: Study

A new study published in the Journal of Inflammation Research showed that ruptured abdominal aortic aneurysms (rAAAs) may be distinguished from unruptured instances by elevated neutrophil counts.

Abdominal aortic aneurysm (AAA) is defined by the abdominal aorta expanding by more than 50% of its usual diameter. This results in aortic rupture and bleeding because of inflammation and medial layer deterioration brought on by immune cells. AAA affects around 8% of males over 65, with an incidence that varies between 1.2% and 2%.

In the early stages of AAAs, there are no noticeable symptoms; yet, as the condition worsens, the aneurysm steadily enlarges, increasing the danger of rupture, which can result in a 90% death rate. The identification of blood biomarkers is easier, faster, less expensive, and safer. For the early differential identification of rAAAs from unruptured AAAs, there is currently no practical and efficient indication. Thus, this study investigated the markers for the early differential diagnosis of rAAAs in a clinical context.

During the previous 5 years, a total of 276 people (220 patients with unruptured AAAs and 56 patients with rAAAs) were included in this case-control research. Following subgroup analysis, 229 subjects (186 patients with unruptured AAAs and 43 patients with rAAAs) were included. Logistic regression analysis and univariate analysis were used to filter the significant markers. Decision curve analysis (DCA), clinical impact curve (CIC), and receiver operating characteristic (ROC) curve analysis were used to evaluate and compare the indicators' clinical utility and diagnostic performance.

In the original model, a high venous blood neutrophil count was identified as a risk factor for rAAAs. Following subgroup analysis, patients with a rAAA had substantially higher levels of neutrophils and D-dimer. The rupture of AAA was closely linked to both back and abdominal discomfort. Neutrophils and NLR demonstrated good diagnostic performance for rAAA, according to the receiver operating characteristic (ROC) study results.

The net benefit of neutrophils was shown by DCA to be higher than those of other markers. The model's strong clinical applicability was validated by the CIC. Overall, patients with rAAA had a higher frequency of raised neutrophil counts. In individuals with a known AAA, neutrophil counts may help distinguish between ruptured and unruptured AAAs, thereby improving clinical decision-making and early identification. 

Source:

Zhang, J., He, Z., Zheng, L., He, X., Li, J., & Zhang, L. (2025). Factors influencing early diagnosis of ruptured abdominal aortic aneurysms: The role of neutrophils. Journal of Inflammation Research, 18, 5777–5790. https://doi.org/10.2147/jir.s512895