Sex differences in hospital outcomes of medically-managed type B aortic dissection
BackgroundMedical management is recommended for uncomplicated type B aortic dissection (TBAD). However, data focused on sex differences in outcomes in TBAD patients managed medically are limited.MethodsHospitalizations of adults with TBAD were identified using the 2016–2019 Nationwide Readmissions D...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-05-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1597266/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850036037100765184 |
|---|---|
| author | Paulina Luna Faris Amil Mary J. Roman Nickpreet Singh Teagan Iranitalab Jim W. Cheung Ilhwan Yeo Richard B. Devereux Jonathan Weinsaft Leonard Girardi Alicia Mecklai Rebecca Ascunce Julie Marcus Pritha Subramanyam Amrita Krishnamurthy Diala Steitieh Luke Kim Nupoor Narula |
| author_facet | Paulina Luna Faris Amil Mary J. Roman Nickpreet Singh Teagan Iranitalab Jim W. Cheung Ilhwan Yeo Richard B. Devereux Jonathan Weinsaft Leonard Girardi Alicia Mecklai Rebecca Ascunce Julie Marcus Pritha Subramanyam Amrita Krishnamurthy Diala Steitieh Luke Kim Nupoor Narula |
| author_sort | Paulina Luna |
| collection | DOAJ |
| description | BackgroundMedical management is recommended for uncomplicated type B aortic dissection (TBAD). However, data focused on sex differences in outcomes in TBAD patients managed medically are limited.MethodsHospitalizations of adults with TBAD were identified using the 2016–2019 Nationwide Readmissions Database. TBAD diagnosis was deduced by inclusion of thoracic or thoracoabdominal aorta dissection and exclusion of presumed type A aortic dissection. Hospitalizations associated with intervention were excluded. Multivariable logistic regression modeling was used to investigate the association of sex with in-hospital mortality. A Cox proportional hazards model was used to assess the association between sex and readmission rates.ResultsThere were 52,269 TBAD hospitalizations (58% male). Compared to men, women were older (72 vs. 65 years), had higher in-hospital mortality (11.5% vs. 8.5%), shorter median length of stay (3.95 vs. 4.23 days), and lower rates of elective admissions (6.4% vs. 8.2%) (all p < 0.05). Despite similar rates of hypertension, lower rates of coronary artery disease and smoking, and decreased rates of hospital-related complications, women experienced increased adjusted in-hospital mortality (odds ratio: 1.16; 95% CI, 1.06–1.27). There were no sex differences in readmission risk at 30, 90, and 180 days.ConclusionsWomen with TBAD managed medically experienced higher in-hospital mortality than men despite lower rates of atherosclerotic disease and risk factors. However, there were no sex differences in readmission risk at 30, 90, and 180 days. Prior research has demonstrated sex differences in presenting TBAD characteristics, including older age, varied signs/symptoms, and diagnostic delay in women. Data are needed to delineate additional causes of adverse acute outcomes in women managed medically, including condition- and medication-specific factors. |
| format | Article |
| id | doaj-art-f791d9c246e14dffbeff7dff06987b8f |
| institution | DOAJ |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-f791d9c246e14dffbeff7dff06987b8f2025-08-20T02:57:19ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-05-011210.3389/fcvm.2025.15972661597266Sex differences in hospital outcomes of medically-managed type B aortic dissectionPaulina Luna0Faris Amil1Mary J. Roman2Nickpreet Singh3Teagan Iranitalab4Jim W. Cheung5Ilhwan Yeo6Richard B. Devereux7Jonathan Weinsaft8Leonard Girardi9Alicia Mecklai10Rebecca Ascunce11Julie Marcus12Pritha Subramanyam13Amrita Krishnamurthy14Diala Steitieh15Luke Kim16Nupoor Narula17Department of Internal Medicine, New York-Presbyterian Hospital, New York, NY, United StatesDepartment of Internal Medicine, New York-Presbyterian Hospital, New York, NY, United StatesDivision of Cardiology, Weill Cornell Medicine, New York, NY, United StatesDivision of Cardiology, Weill Cornell Medicine, New York, NY, United StatesDepartment of Medicine, Division of Cardiology, Weill Cornell Cardiovascular Outcomes Research Group (CORG), New York, NY, United StatesDepartment of Medicine, Division of Cardiology, Weill Cornell Cardiovascular Outcomes Research Group (CORG), New York, NY, United StatesDepartment of Medicine, Division of Cardiology, Weill Cornell Cardiovascular Outcomes Research Group (CORG), New York, NY, United StatesDivision of Cardiology, Weill Cornell Medicine, New York, NY, United StatesDivision of Cardiology, Weill Cornell Medicine, New York, NY, United StatesDepartment of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United StatesDivision of Cardiology, Weill Cornell Medicine, New York, NY, United StatesDivision of Cardiology, Weill Cornell Medicine, New York, NY, United StatesDivision of Cardiology, Weill Cornell Medicine, New York, NY, United StatesDivision of Cardiology, Weill Cornell Medicine, New York, NY, United StatesDivision of Cardiology, Weill Cornell Medicine, New York, NY, United StatesDivision of Cardiology, Weill Cornell Medicine, New York, NY, United StatesDepartment of Medicine, Division of Cardiology, Weill Cornell Cardiovascular Outcomes Research Group (CORG), New York, NY, United StatesDivision of Cardiology, Weill Cornell Medicine, New York, NY, United StatesBackgroundMedical management is recommended for uncomplicated type B aortic dissection (TBAD). However, data focused on sex differences in outcomes in TBAD patients managed medically are limited.MethodsHospitalizations of adults with TBAD were identified using the 2016–2019 Nationwide Readmissions Database. TBAD diagnosis was deduced by inclusion of thoracic or thoracoabdominal aorta dissection and exclusion of presumed type A aortic dissection. Hospitalizations associated with intervention were excluded. Multivariable logistic regression modeling was used to investigate the association of sex with in-hospital mortality. A Cox proportional hazards model was used to assess the association between sex and readmission rates.ResultsThere were 52,269 TBAD hospitalizations (58% male). Compared to men, women were older (72 vs. 65 years), had higher in-hospital mortality (11.5% vs. 8.5%), shorter median length of stay (3.95 vs. 4.23 days), and lower rates of elective admissions (6.4% vs. 8.2%) (all p < 0.05). Despite similar rates of hypertension, lower rates of coronary artery disease and smoking, and decreased rates of hospital-related complications, women experienced increased adjusted in-hospital mortality (odds ratio: 1.16; 95% CI, 1.06–1.27). There were no sex differences in readmission risk at 30, 90, and 180 days.ConclusionsWomen with TBAD managed medically experienced higher in-hospital mortality than men despite lower rates of atherosclerotic disease and risk factors. However, there were no sex differences in readmission risk at 30, 90, and 180 days. Prior research has demonstrated sex differences in presenting TBAD characteristics, including older age, varied signs/symptoms, and diagnostic delay in women. Data are needed to delineate additional causes of adverse acute outcomes in women managed medically, including condition- and medication-specific factors.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1597266/fullsex disparitiestype B aortic dissectionreadmissionshospital outcomesnational readmissions database (NRD) |
| spellingShingle | Paulina Luna Faris Amil Mary J. Roman Nickpreet Singh Teagan Iranitalab Jim W. Cheung Ilhwan Yeo Richard B. Devereux Jonathan Weinsaft Leonard Girardi Alicia Mecklai Rebecca Ascunce Julie Marcus Pritha Subramanyam Amrita Krishnamurthy Diala Steitieh Luke Kim Nupoor Narula Sex differences in hospital outcomes of medically-managed type B aortic dissection Frontiers in Cardiovascular Medicine sex disparities type B aortic dissection readmissions hospital outcomes national readmissions database (NRD) |
| title | Sex differences in hospital outcomes of medically-managed type B aortic dissection |
| title_full | Sex differences in hospital outcomes of medically-managed type B aortic dissection |
| title_fullStr | Sex differences in hospital outcomes of medically-managed type B aortic dissection |
| title_full_unstemmed | Sex differences in hospital outcomes of medically-managed type B aortic dissection |
| title_short | Sex differences in hospital outcomes of medically-managed type B aortic dissection |
| title_sort | sex differences in hospital outcomes of medically managed type b aortic dissection |
| topic | sex disparities type B aortic dissection readmissions hospital outcomes national readmissions database (NRD) |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1597266/full |
| work_keys_str_mv | AT paulinaluna sexdifferencesinhospitaloutcomesofmedicallymanagedtypebaorticdissection AT farisamil sexdifferencesinhospitaloutcomesofmedicallymanagedtypebaorticdissection AT maryjroman sexdifferencesinhospitaloutcomesofmedicallymanagedtypebaorticdissection AT nickpreetsingh sexdifferencesinhospitaloutcomesofmedicallymanagedtypebaorticdissection AT teaganiranitalab sexdifferencesinhospitaloutcomesofmedicallymanagedtypebaorticdissection AT jimwcheung sexdifferencesinhospitaloutcomesofmedicallymanagedtypebaorticdissection AT ilhwanyeo sexdifferencesinhospitaloutcomesofmedicallymanagedtypebaorticdissection AT richardbdevereux sexdifferencesinhospitaloutcomesofmedicallymanagedtypebaorticdissection AT jonathanweinsaft sexdifferencesinhospitaloutcomesofmedicallymanagedtypebaorticdissection AT leonardgirardi sexdifferencesinhospitaloutcomesofmedicallymanagedtypebaorticdissection AT aliciamecklai sexdifferencesinhospitaloutcomesofmedicallymanagedtypebaorticdissection AT rebeccaascunce sexdifferencesinhospitaloutcomesofmedicallymanagedtypebaorticdissection AT juliemarcus sexdifferencesinhospitaloutcomesofmedicallymanagedtypebaorticdissection AT prithasubramanyam sexdifferencesinhospitaloutcomesofmedicallymanagedtypebaorticdissection AT amritakrishnamurthy sexdifferencesinhospitaloutcomesofmedicallymanagedtypebaorticdissection AT dialasteitieh sexdifferencesinhospitaloutcomesofmedicallymanagedtypebaorticdissection AT lukekim sexdifferencesinhospitaloutcomesofmedicallymanagedtypebaorticdissection AT nupoornarula sexdifferencesinhospitaloutcomesofmedicallymanagedtypebaorticdissection |