Influence of socioeconomic status on postoperative outcomes in acute type A aortic dissection repairCentral MessagePerspective
Objective: Type A aortic dissection repair is an emergency operation associated with both higher perioperative and postoperative risk. This study investigates the influence of socioeconomic status, as measured by the Distressed Communities Index (DCI), on patients who underwent acute aortic dissecti...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-04-01
|
| Series: | JTCVS Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666273625000397 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850201054898028544 |
|---|---|
| author | Benjamin Hambright, BS Lamario Williams, MD, PhD Rongbing Xie, DrPH, MPH Sasha A. Still, MD |
| author_facet | Benjamin Hambright, BS Lamario Williams, MD, PhD Rongbing Xie, DrPH, MPH Sasha A. Still, MD |
| author_sort | Benjamin Hambright, BS |
| collection | DOAJ |
| description | Objective: Type A aortic dissection repair is an emergency operation associated with both higher perioperative and postoperative risk. This study investigates the influence of socioeconomic status, as measured by the Distressed Communities Index (DCI), on patients who underwent acute aortic dissection repair and their postoperative outcomes. Methods: We conducted a retrospective analysis of 240 adult patients who underwent repair for acute Stanford Type A aortic dissection from 2009 to 2021. Patients were categorized into an at-risk group (DCI score ≥75) and a not-at-risk group (DCI score <75) based on their zip code. We collected demographic, clinical, operative, and postoperative outcomes, analyzing data using descriptive statistics and multivariable logistic regression. Kaplan-Meier survival analysis assessed 5-year survival outcomes. Results: At-risk patients were significantly younger (52 vs 59 years; P = .03) and more commonly African American (59.02% vs 26.5%; P < .0001). Although chronic health condition rates were similar, at-risk patients showed trends toward higher rates of postoperative respiratory failure (27.1% vs 18.0%; P = .0926) and longer hospital stays (27.05% vs 15.25% for length of stay of 8-13 days; P = .065). However, rates of postoperative complications, including 30-day mortality and 5-year survival, were not significantly different between groups, and at-risk status did not significantly predict mortality (hazard ratio, 1.35; 95% CI, 0.65-2.79; P = .43). Conclusions: Patients undergoing urgent surgery for acute Type A aortic dissection have similar postoperative outcomes, although at-risk patients may experience longer hospital stays and higher respiratory failure rates. Further study is necessary to understand the effect of DCI score on intermediate and long-term outcomes to mitigate social disparities and diminish modifiable risk factors. |
| format | Article |
| id | doaj-art-bebef98c720e41eaa95f00c1b1f77dda |
| institution | OA Journals |
| issn | 2666-2736 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Open |
| spelling | doaj-art-bebef98c720e41eaa95f00c1b1f77dda2025-08-20T02:12:08ZengElsevierJTCVS Open2666-27362025-04-012433234010.1016/j.xjon.2025.01.013Influence of socioeconomic status on postoperative outcomes in acute type A aortic dissection repairCentral MessagePerspectiveBenjamin Hambright, BS0Lamario Williams, MD, PhD1Rongbing Xie, DrPH, MPH2Sasha A. Still, MD3Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AlaHeersink School of Medicine, University of Alabama at Birmingham, Birmingham, AlaDivision of Cardiothoracic Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AlaDivision of Cardiothoracic Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Ala; Address for reprints: Sasha A. Still, MD, Division of Cardiothoracic Surgery, Department of Surgery, University of Alabama at Birmingham, 1900 University Blvd, Birmingham, AL 35233.Objective: Type A aortic dissection repair is an emergency operation associated with both higher perioperative and postoperative risk. This study investigates the influence of socioeconomic status, as measured by the Distressed Communities Index (DCI), on patients who underwent acute aortic dissection repair and their postoperative outcomes. Methods: We conducted a retrospective analysis of 240 adult patients who underwent repair for acute Stanford Type A aortic dissection from 2009 to 2021. Patients were categorized into an at-risk group (DCI score ≥75) and a not-at-risk group (DCI score <75) based on their zip code. We collected demographic, clinical, operative, and postoperative outcomes, analyzing data using descriptive statistics and multivariable logistic regression. Kaplan-Meier survival analysis assessed 5-year survival outcomes. Results: At-risk patients were significantly younger (52 vs 59 years; P = .03) and more commonly African American (59.02% vs 26.5%; P < .0001). Although chronic health condition rates were similar, at-risk patients showed trends toward higher rates of postoperative respiratory failure (27.1% vs 18.0%; P = .0926) and longer hospital stays (27.05% vs 15.25% for length of stay of 8-13 days; P = .065). However, rates of postoperative complications, including 30-day mortality and 5-year survival, were not significantly different between groups, and at-risk status did not significantly predict mortality (hazard ratio, 1.35; 95% CI, 0.65-2.79; P = .43). Conclusions: Patients undergoing urgent surgery for acute Type A aortic dissection have similar postoperative outcomes, although at-risk patients may experience longer hospital stays and higher respiratory failure rates. Further study is necessary to understand the effect of DCI score on intermediate and long-term outcomes to mitigate social disparities and diminish modifiable risk factors.http://www.sciencedirect.com/science/article/pii/S2666273625000397DCIaortic dissectionhealth disparities |
| spellingShingle | Benjamin Hambright, BS Lamario Williams, MD, PhD Rongbing Xie, DrPH, MPH Sasha A. Still, MD Influence of socioeconomic status on postoperative outcomes in acute type A aortic dissection repairCentral MessagePerspective JTCVS Open DCI aortic dissection health disparities |
| title | Influence of socioeconomic status on postoperative outcomes in acute type A aortic dissection repairCentral MessagePerspective |
| title_full | Influence of socioeconomic status on postoperative outcomes in acute type A aortic dissection repairCentral MessagePerspective |
| title_fullStr | Influence of socioeconomic status on postoperative outcomes in acute type A aortic dissection repairCentral MessagePerspective |
| title_full_unstemmed | Influence of socioeconomic status on postoperative outcomes in acute type A aortic dissection repairCentral MessagePerspective |
| title_short | Influence of socioeconomic status on postoperative outcomes in acute type A aortic dissection repairCentral MessagePerspective |
| title_sort | influence of socioeconomic status on postoperative outcomes in acute type a aortic dissection repaircentral messageperspective |
| topic | DCI aortic dissection health disparities |
| url | http://www.sciencedirect.com/science/article/pii/S2666273625000397 |
| work_keys_str_mv | AT benjaminhambrightbs influenceofsocioeconomicstatusonpostoperativeoutcomesinacutetypeaaorticdissectionrepaircentralmessageperspective AT lamariowilliamsmdphd influenceofsocioeconomicstatusonpostoperativeoutcomesinacutetypeaaorticdissectionrepaircentralmessageperspective AT rongbingxiedrphmph influenceofsocioeconomicstatusonpostoperativeoutcomesinacutetypeaaorticdissectionrepaircentralmessageperspective AT sashaastillmd influenceofsocioeconomicstatusonpostoperativeoutcomesinacutetypeaaorticdissectionrepaircentralmessageperspective |