Abstract 10519: The Epidemiology of Race- and Sex-Specific Hospitalizations for Abdominal Aortic Aneurysms

Abstract

Introduction: Established predominantly among White males, early detection of abdominal aortic aneurysms (AAA) with risk-factor guided screening decreases AAA-related mortality. Minimal epidemiologic data exists for AAA in racial and sex minority groups despite having increased morbidity and mortality following repair. Methods: Using data from the National Inpatient Sample and US Census (2012-18), we quantified age, race, and sex-specific incidences of intact and ruptured AAA (iAAA, rAAA) hospitalizations, associated risk factors, and in-hospital mortality. Adjusted odds ratios (OR) quantified AAA hospitalization and mortality risks. Interaction terms evaluated subgroups. Results: Of 1,728,374,183 US residents (78% White, 13% Black, 6% Asian; 51% female), 211,501,703 were hospitalized (65% White, 14% Black, 3% Asian; 58% female) with 291,850 for AAA (82% White, 6% Black, 2% Asian; 23% female). AAA hospitalizations were highest for Whites and males ( Fig ). For iAAA, compared to Whites, Blacks (OR 0.5 [95%CI 0.4-0.5]) and Asians (OR 0.9 [95%CI 0.8-0.9]) and compared to males, females (OR 0.3 [95%CI 0.3-0.3]) had reduced odds of hospitalization. For rAAA, reduced odds of hospitalization for Blacks (OR 0.5 [95%CI 0.5-0.6]) and females (OR 0.3 [95%CI 0.3-0.3]) persisted, but not for Asians (OR 1.0 [95%CI 0.8-1.2]). In subgroup analysis, associations between AAA hospitalizations, race and sex were smaller and closer to Whites and males for Black females and Blacks and females who were older or had peripheral vascular disease (PVD; P-interactions <0.001). Female sex (OR 1.5 [95%CI 1.4-1.7]) but not Black and Asian races, was associated with increased mortality. Conclusions: Black and Asian races and female sex were associated with substantial decrease while older age and PVD conferred increase in the contemporary incidence and odds of AAA hospitalizations. However, AAA screening guidelines do not include PVD or race-specific differences. Changes may be warranted.