Socioeconomic disparities affect survival after aortic dissection

Area of Science:

• Cardiovascular Medicine
• Health Services Research
• Public Health

Background:

• Socioeconomic status (SES) is a known determinant of health outcomes across various diseases.
• However, its impact on aortic dissection, a critical cardiovascular emergency, remains understudied.
• Understanding SES-related disparities is crucial for equitable patient care.

Purpose of the Study:

• To investigate the association between socioeconomic status (SES) and survival rates in patients diagnosed with aortic dissection.
• To evaluate the impact of SES on both 30-day and long-term mortality following aortic dissection.

Main Methods:

• Utilized hospital discharge records to identify 212 patients with acute aortic dissection (118 Type A, 94 Type B).
• Assessed SES using the neighborhood deprivation index, derived from patient home addresses.
• Analyzed 30-day mortality and long-term survival via the Social Security Death Index, controlling for demographics and comorbidities.

Main Results:

• A higher neighborhood deprivation index (indicating lower SES) was significantly associated with reduced long-term survival (HR 1.43, P=.001) and increased 30-day mortality (HR 1.43, P=.02).
• Patients with Type B aortic dissections exhibited higher mean neighborhood deprivation index scores compared to those with Type A dissections (P=.029).

Conclusions:

• Lower socioeconomic status is a significant predictor of poorer short-term and long-term survival following aortic dissection.
• Patients with Type B aortic dissections are more likely to reside in socioeconomically disadvantaged neighborhoods.