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Impact of Ethnicity and Race on Outcomes after Thoracic Endovascular Aortic Repair
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  • Carlos Diaz-Castrillon,
  • Derek Serna-Gallegos,
  • Edgar Aranda-Michel,
  • James Brown,
  • Sarah Yousef,
  • Floyd Thoma,
  • Yisi Wang,
  • Ibrahim Sultan
Carlos Diaz-Castrillon
University of Pittsburgh Department of Cardiothoracic Surgery

Corresponding Author:[email protected]

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Derek Serna-Gallegos
University of Pittsburgh Department of Cardiothoracic Surgery
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Edgar Aranda-Michel
University of Pittsburgh Department of Cardiothoracic Surgery
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James Brown
University of Pittsburgh Department of Cardiothoracic Surgery
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Sarah Yousef
University of Pittsburgh Department of Cardiothoracic Surgery
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Floyd Thoma
UPMC Heart and Vascular Institute
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Yisi Wang
UPMC Heart and Vascular Institute
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Ibrahim Sultan
University of Pittsburgh Department of Cardiothoracic Surgery
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Abstract

Introduction Thoracic endovascular aortic repair (TEVAR) became the standard of care for treating type B aortic dissections and descending thoracic aortic aneurysms. We aimed to describe the racial/ethnic differences in TEVAR utilization and outcomes. Methods The National Inpatient Sample was reviewed for all TEVARs performed between 2010 and 2017 for Type B aortic dissection and descending thoracic aortic aneurysm (DTAA). We compared groups stratifying by their racial/ethnicity background in whites, black, Hispanic, and others. A mixed-effects logistic regression was performed to assess the relationship between race/ethnicity and the primary outcome, in-hospital mortality. Results A total of 25,260 admissions for TEVAR during 2010–2017 were identified. Of those, 52.74% (n= 13,322) were performed for aneurysm and 47.2% (n= 11,938) were performed for type B dissection. 68.1% were white, 19.6% were black, 5.7% Hispanic, and 6.5% were classified as others. White patients were the oldest (median age 71 years; <0.001), with TEVAR being performed electively more often for aortic aneurysm (58.8% vs. 34% vs. 48.3% vs. 48.2%; p<0.001). In contrast, TEVAR was more likely urgent or emergent for type B dissection in black patients (65.6% vs 41.1% vs 51.6% vs 51.7%; p<0.001). Finally, the black population showed a relative increase in the incidence rate of TEVAR over time. The adjusted multivariable model showed that race/ethnicity was not associated with in-hospital mortality. Conclusion Although there is a differential distribution of thoracic indication and comorbidities between race/ethnicity in TEVAR, racial disparities do not appear to be associated with in-hospital mortality after adjusting for covariates.
23 Mar 2022Submitted to Journal of Cardiac Surgery
23 Mar 2022Submission Checks Completed
23 Mar 2022Assigned to Editor
23 Mar 2022Reviewer(s) Assigned
05 Apr 2022Review(s) Completed, Editorial Evaluation Pending
06 Apr 2022Editorial Decision: Accept
Aug 2022Published in Journal of Cardiac Surgery volume 37 issue 8 on pages 2317-2323. 10.1111/jocs.16580