Abstract 11121: In-Hospital Outcomes of Aortic Dissection in Patients With Substance Use Disorder

Abstract

Introduction: Substance Use Disorder (SUD) is a chronic relapsing disease emanating from the uncontrolled use of drugs despite devastating physical, neurologic and psychological consequences. Studies have proven an association of SUD with a variety of life-threatening cardiac conditions. Aortic dissection (AD) is an acute condition caused by a tear in the inner layer of the aorta and requires immediate intervention. Our study aimed to ascertain the in-hospital outcomes of patients with substance use disorders presenting with Aortic dissection using a national representative sample. Methods: This was a retrospective study done using the 2016-2019 National inpatient sample, ICD 10 codes were used to identify individuals who were admitted for aortic dissection who were further categorized into two groups based on a history of SUD or not. Multivariate analysis was used to control for confounders and assess in-hospital mortality and other hospital outcomes. Results: A total of 63,380 patients were admitted for Aortic dissection during the study period. 26% (16,775) of the population sample had active abuse of at least 1 substance. AD was identified in a younger age group with SUD vs those without SUD with a mean age of 57. vs 65 years respectively. 68% of patients with SUD were found to be males with the predominant race being white (56%). A higher proportion of SUD patients had co-morbid Hypertension (60%) and smoked Cigarette (92%). Comparing both groups, there was no statistical difference in in-hospital mortality (AOR 1.06, 95% CI 0.88-1.26, p=0.50). However, there was a higher risk of acute coronary syndrome (AOR 1.77, 95% CI 1.20-2.40, p= 0.01), Cardiogenic shock (AOR 1.26, 95% CI 1.01-1.57, p< 0.001) and Embolic stroke (AOR 1.33, 95% CI 1.05-1.67, p=0.019) in the SUD group. We also observed no difference in the mean length of stay (adjusted coefficient 0.456, 95% CI 0.049- 0.96, p=0.077) or the mean of total hospital charges (adjusted coefficient 3882, 95% CI -10548.17- 18313.79, p= 0.60) in both groups. Conclusions: We observed that in hospitalized patients with AD, SUD is not associated with an increased risk of in-hospital mortality, however, there is a significantly increased risk of cardiogenic shock, coronary syndrome, and embolic stroke.