Abstract 11711: Factors Predicting Acute Ischemic Stroke Following Surgical Repair of Acute Type A Aortic Dissection (ATAAD) in Adults

Abstract

Introduction: Acute type A Aortic dissection (ATAAD) may require urgent surgical repair, and a major complication is acute ischemic stroke (AIS) post-surgery. Aim: To explore characteristics associated with AIS in ATAAD patients post-surgical repair (PSR). Hypothesis: We assessed the hypothesis that multiple factors influence events of AIS in ATAAD patients PSR. Method: Multivariate regression analysis for factors influencing AIS in adults with a principal diagnosis of ATAAD and undergoing surgical repair was performed via the 2016-2020 National Inpatient Sample. Results: Among the 20335 ATAAD cases with surgical repair, 14.7%(2985 cases) reported an event of AIS. Individuals ≥60 years (vs. ages 18-39 years, aOR 1.323, p=0.007) and presence of hypertension (aOR 1.228, P<.001), acute kidney injury (AKI) (aOR 1.353, P<.001), Charlson Comorbidity Index (CCI) ≥3 (aOR 15.129, p<.001), and Private insurances (vs. Medicare, aOR 1.454, p<.001) or Medicaid (vs. Medicare, aOR 1.673, p<.001) showed higher odds of developing AIS. On the contrary, smoking (aOR 0.613, p<.001), obesity (aOR 0.882, p=0.027), cirrhosis (aOR 0.309, p<.001), dyslipidemia (aOR 0.732, p<.001), diabetes (DM) (aOR 0.508, p<.001), peripheral vascular disease (PVD) (aOR 0.615, p<.001), Chronic Kidney Disease (CKD) (aOR 0.446, p<.001), prior MI (aOR 0.461, p<.001) and prior stroke (aOR 0.788, p=0.04) and Black race (aOR 0.736, p<.001) indicated lower odds. No significant difference was seen in age 40-59 (aOR 1.06, p=0.545), drug abuse (aOR 1.093, p=0.451), alcohol abuse (aOR 0.925, p=0.476), Females (vs. Males, aOR 0.973, p=0.579), and Hispanics (vs. Whites, aOR 1.102, p=0.285). Conclusion: In conclusion, a 14.7% rate of AIS in ATAAD PSR was observed. Ages ≥60, hypertension, AKI, CCI ≥3, and Private and Medicaid insurance holders appeared prone to AIS following such events, while smoking, obesity, cirrhosis, dyslipidemia, DM, PVD, CKD, prior MI, prior stroke, and Blacks had reduced odds.