Racial disparities in surgical treatment of type A acute aortic dissection

JTCVS Open · 5 authors, 3 centres

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FIDELITY 100%

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AGENT 01 · STRUCTURED SUMMARY

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TL;DR

The primary outcome was in-hospital mortality.

Full summary

863 CHARS

The primary outcome was in-hospital mortality. The study found significant differences in presentation: Black/African American and Hispanic admissions had a median age of 54 and 55 years, respectively, compared to 64 years for White admissions. A higher percentage of Black and Hispanic admissions were from the lowest income quartile. Despite these disparities in presentation, multivariable logistical modeling revealed no independent association between race and in-hospital mortality after adjusting for age and comorbidity. Secondary outcomes showed differences in resource utilization, with Hispanic admissions having a longer median length of stay and higher total cost. Limitations include reliance on an administrative database which may not capture all complications and the inability to determine if certain complications were present before admission.

STUDY TYPE

cohort

SPECIALTY

cardiology

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10328814

Racial disparities in surgical treatment of type A acute aortic dissection

JTCVS Open

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ABSTRACT

Abstract Objective To determine whether there are racial disparities associated with mortality, cost, and length of hospital stay after surgical repair of type A acute aortic dissection (TAAAD). Methods Patient data from 2015 to 2018 were collected using the National Inpatient Sample. In-hospital mortality was the primary outcome. Multivariable logistical modeling was used to identify factors independently associated with mortality. Results Among 3952 admissions, 2520 (63%) were White, 848 (21%) were Black/African American, 310 (8%) were Hispanic, 146 (4%) were Asian and Pacific Islander (API), and 128 (3%) were classified as Other. Black/African American and Hispanic admissions presented with TAAAD at a median age of 54 years and 55 years, respectively, whereas White and API admissions presented at a median age of 64 years and 63 years, respectively ( P < .0001). Additionally, there were higher percentages of Black/African American (54%; n = 450) and Hispanic (32%; n = 94) admissions living in ZIP codes with the lowest median household income quartile. Despite these differences on presentation, when adjusting for age and comorbidity, there was no independent association between race and in-hospital mortality and no significant interactions between race and income on in-hospital mortality. Conclusions Black and Hispanic admissions present with TAAAD a decade earlier than White and API admissions. Additionally, Black and Hispanic TAAAD admissions are more likely to come from lower-income households. After adjusting for relevant cofactors, there was no independent association between race and in-hospital mortality after surgical treatment of TAAAD. Key Words: aortic dissection, racial disparities, type A aortic dissection

CITATION EXPORT

Adhana Asfaw, Yuming Ning, Adrianna Bergstein et al.. Racial disparities in surgical treatment of type A acute aortic dissection. JTCVS Open. (2023). https://doi.org/10.1016/j.xjon.2023.02.002

AUTHORS

5 · 3 CENTRES

Adhana Asfaw, Yuming Ning, Adrianna Bergstein, Hiroo Takayama, Paul Kurlansky

aVagelos College of Physicians and Surgeons, Columbia University, New York, NY
bDepartment of Surgery, Center for Innovation and Outcomes Research, Columbia University, New York, NY
cDivision of Cardiac Surgery, Department of Surgery, Columbia University, New York, NY