Abstract 10046: Racial Disparity in Patients Undergoing Thoracic Endovascular Aortic Repair for Thoracic Aortic Aneurysms and Dissections

Abstract

Introduction: Thoracic Endovascular Aortic Repair (TEVAR) has become the standard of care for treating complicated type B aortic dissection and descending thoracic aortic aneurysms. There are no large datasets evaluating racial disparities in patients undergoing TEVAR. Hypothesis: There is no difference in outcomes between patients of different ethnicities and race undergoing TEVAR. Methods: We analyzed adult patients who underwent TEVAR for complicated type B aortic dissection or descending thoracic aortic aneurysm. International Classification of Diseases, Ninth Revision, were used to identify patients. We utilized the National Inpatient Sample database, from January 1, 2010 to December 31, 2017. Appropriate trend weights were used to generate national estimates. Primary outcome measure was in hospital mortality. Predictors of mortality were determined using hierarchical logistic regression and a mixed logistic model was used to account for hospital variations. Excluded patients were less than 18 years old. Results: The study population consisted of 25260 patients. There were 17197 (68.07%) white patients, 4959 (19.66%) black patients, 1462 (5.74%) Hispanic patients and 1642 (6.51%) patients of various other ethnicities and races. Although the Elixhauser comorbidity index was not significantly different between groups, white patients were older, underwent more elective repairs, had lower baseline rates of diabetes mellitus, hypertension and chronic kidney disease. There was no significant difference when comparing in hospital mortality between white (reference group), black (OR 0.86, p=0.46), Hispanic (OR 1.54, p=0.13) or other groups (OR 0.78, p=0.45). Non elective TEVAR (OR 2.23, p<0.001), presence of other cardiac conditions (OR 2.68, p<0.001), and preoperative diagnosis of cerebral vascular disease (OR 2.39, p<0.001), peripheral vascular disease (OR 1.62, p=0.00) and chronic kidney disease (OR 1.45, p=0.04) were significant predictors of in hospital mortality. Conclusions: While patients of color were older and had more peripheral vascular disease and chronic obstructive pulmonary disease racial differences did not predict in hospital mortality.