Abstract 103: Socioeconomic Factors and Illicit Drug Use Affect Time to Presentation in Ascending Aortic Dissection

Abstract

Objectives: Ascending aortic dissection (AoD) is the most lethal condition involving the aorta. Despite increased awareness of AoD among clinicians and improvements in diagnostic imaging and treatment, the mortality and morbidity rates of this condition remain high. To further optimize outcomes, symptom onset and its impact on presentation is needed. The objective of this study was to determine whether socioeconomic factors and legal or illegal drug use were associated with delays in presentation of ascending AoD patients. Methods: In this study, 186 patients with complete data presenting with ascending AoD from 2007 to 2016 to 2 tertiary hospitals were retrospectively studied. Symptom-onset-to-hospital-arrival time was analyzed for: legal and illegal substance use, ethnicity, insurance status, gender, and marital status. Symptom onset time was identified by review of medical records and emergency services data. Statistical analysis was carried out to compare differences in time to presentation between groups. Results: See tables 1 and 2 Conclusions: In this cohort, illicit drug use and tobacco use were associated with significant barriers to presentation in patients with ascending AoD. In addition, ascending AoD patients who were female, Hispanic, uninsured, and widowed presented significantly later than the other patient groups. Contrary to expectation, alcohol use was not associated with pre-hospital delays. Enhanced public awareness and targeted education to these vulnerable patient groups are necessary to decrease pre-hospital delays, reduce barriers to presentation, and further improve clinical outcomes in ascending AoD patients.