Abstract 14196: Methamphetamine Use is Associated With Increased In-Hospital Mortality After Aortic Dissection: The National Inpatient Sample Perspective

Abstract

Introduction: Aortic dissection is a rare complication associated with methamphetamine abuse. Mortality in aortic dissection is high, however outcomes in methamphetamine associated aortic dissection have not been investigated. In this study, we describe the impact of methamphetamine use on in-hospital mortality in patient who presented with an acute aortic dissection using a large inpatient database. Methods: We queried the 2017 National Inpatient Sample database to identify all admissions age 18 years or older with a discharge diagnosis of aortic dissection. We accounted for survey design and built a multivariable logistic regression model to evaluate the impact of methamphetamine use on in-hospital mortality after an acute aortic dissection, while controlling for patient demographics, hospital characteristics and multiple co-morbid conditions. Results: A total of 30,060 cases of acute aortic dissection were identified, of which 395 had a history of methamphetamine use disorder. Patients with aortic dissection and history of methamphetamine use disorder were younger, male with higher incidence of co-morbid smoking and history hypertension compared to those without history of methamphetamine use disorder (Table 1). We found that in-hospital mortality for aortic dissection was significantly higher among methamphetamine users despite controlling for multiple co-morbid conditions and patient demographics, OR 3.52 (95% CI 1.73 - 7.13); p - value 0.001. Conclusions: To our knowledge, this is the first population study to demonstrate that patients with a history of methamphetamine use disorder are at increased risk of death in the hospital after acute aortic dissection. Factors contributing to these findings necessitates further prospective investigations to prevent morbidity. Special attention should be paid to young patients presenting with aortic dissection and methamphetamine use disorder should be suspected.