Race and sex disparities in resource use and outcomes after acute type A aortic dissection repair

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-03-27 DOI:10.1016/j.amjsurg.2025.116323

Carlos E. Diaz-Castrillon , Derek Serna-Gallegos , Shwetabh Tarun , Nidhi Iyanna , Sarah Yousef , Julie Phillippi , Jianhui Zhu , Ibrahim Sultan

{"title":"Race and sex disparities in resource use and outcomes after acute type A aortic dissection repair","authors":"Carlos E. Diaz-Castrillon , Derek Serna-Gallegos , Shwetabh Tarun , Nidhi Iyanna , Sarah Yousef , Julie Phillippi , Jianhui Zhu , Ibrahim Sultan","doi":"10.1016/j.amjsurg.2025.116323","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>Evaluate race-sex-based disparities following acute type A aortic dissection (ATAAD) repair.</div></div><div><h3>Methods</h3><div>retrospective cohort study (2010–2021) conducted at a high-volume referral aortic center. Multivariable regression models were used to assess race- and sex-stratified differences in mortality and resource utilization.</div></div><div><h3>Results</h3><div>Women presented at significantly older ages than men within both racial groups (White: 68 vs. 61 years, p < 0.001; Black: 58.5 vs. 49 years, p = 0.002). Black women had the highest comorbidity burden, with 53 % having ≥3 comorbidities. They also required more intraoperative blood transfusions and had the longest postoperative hospital stays, while White women were more likely to need prolonged mechanical ventilation. In-hospital mortality did not differ significantly by sex/race, but Black patients experienced worse long-term survival, independent of sex.</div></div><div><h3>Conclusion</h3><div>Significant race- and sex-based disparities exist in perioperative care following ATAAD repair. Further research on social determinants of health is needed to understand patient interactions with surgical care.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"244 ","pages":"Article 116323"},"PeriodicalIF":2.7000,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S000296102500145X","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

Evaluate race-sex-based disparities following acute type A aortic dissection (ATAAD) repair.

Methods

retrospective cohort study (2010–2021) conducted at a high-volume referral aortic center. Multivariable regression models were used to assess race- and sex-stratified differences in mortality and resource utilization.

Results

Women presented at significantly older ages than men within both racial groups (White: 68 vs. 61 years, p < 0.001; Black: 58.5 vs. 49 years, p = 0.002). Black women had the highest comorbidity burden, with 53 % having ≥3 comorbidities. They also required more intraoperative blood transfusions and had the longest postoperative hospital stays, while White women were more likely to need prolonged mechanical ventilation. In-hospital mortality did not differ significantly by sex/race, but Black patients experienced worse long-term survival, independent of sex.

Conclusion

Significant race- and sex-based disparities exist in perioperative care following ATAAD repair. Further research on social determinants of health is needed to understand patient interactions with surgical care.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.