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Racial Disparities in Endovascular Aortic Aneurysm Repair.

Adam Tanious1, Nirmani Karunathilake2, Joel Toro2

  • 1Department of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA.

Annals of Vascular Surgery
|November 27, 2018
PubMed
Summary
This summary is machine-generated.

Racial disparities exist in endovascular aortic aneurysm repair (EVAR) access and outcomes. African Americans and Hispanics face longer stays, higher costs, and different surgeon specialties compared to non-Hispanic Whites.

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Area of Science:

  • Vascular Surgery
  • Health Disparities
  • Health Services Research

Background:

  • Racial and ethnic disparities significantly impact healthcare access and outcomes across medical fields.
  • Endovascular aortic aneurysm repair (EVAR) represents a critical technological advancement where such disparities may manifest.
  • Hypothesized that a statewide analysis would reveal race-based disparities in EVAR access and outcomes.

Purpose of the Study:

  • To investigate racial disparities in access to and outcomes of endovascular aortic aneurysm repair (EVAR).
  • To analyze a statewide administrative dataset to identify differences based on patient race.

Main Methods:

  • Utilized de-identified data from Florida's Agency for Health Care Administration (2000-2014).
  • Identified EVAR procedures using ICD-9 codes.
  • Analyzed patient outcomes (hospital charges, length of stay, disposition, payer status) stratified by race and operating physician specialty.

Main Results:

  • 36,601 EVAR procedures were analyzed; the cohort was predominantly male (81.2%) and aged 73.38 years.
  • Significant differences observed in age, sex, and comorbidity scores at presentation across racial groups.
  • Race was significantly associated with total hospital charges, length of stay, patient disposition, and payer status.

Conclusions:

  • Significant racial disparities were identified in EVAR treatment and outcomes.
  • African Americans experienced younger presentation age, higher female intervention rates, longer hospital stays, greater Medicaid use, and higher total charges.
  • Hispanics presented with higher comorbidity scores; both African Americans and Hispanics were more likely to be treated by non-vascular surgeons.