Burden and Predictors of 30- and 90-Day Readmission in Patients With Aortic Dissection: A Nationwide Retrospective...

Aortic dissection (AD) is a life-threatening emergency, with type A requiring surgery and type B generally managed medically. This retrospective cohort study analyzed 30- and 90-day readmission rates using data from the 2016-2017 Nationwide Readmissions Database. Adult patients (≥18 years) with a principal diagnosis of AD were identified by International Classification of Diseases-10th Revision-Clinical Modification codes. Outcomes included 30- and 90-day all-cause readmissions, mortality, length of stay, charges, and causes of readmission. Among 26,477 index admissions, in-hospital mortality was 12.70%. Of the 23,117 survivors, and 11.92% were readmitted within 30 days. Among 21,421 index admissions, in-hospital mortality was 12.57%, and 14.92% were readmitted within 30 days. Readmitted patients were younger and more likely to be insured by Medicaid or Medicare; chronic pulmonary disease and renal failure were the strongest comorbidity signals. In regression models, Medicaid (odds ratio [OR] 1.23-1.36) and Medicare (OR 1.20-1.29), as well as chronic pulmonary disease (OR 1.29-1.34) and renal failure (OR 1.32-1.36), were independently associated with increased risk of readmission. At the same time, older age was associated with a slight reduction (OR 0.99 per year). Hospital factors, sex, and most other comorbidities were not significant. Readmission stays averaged about 6 days, with charges ranging from $99,000 to $106,000. In-hospital mortality was 3%, which is lower than the index mortality rate. Readmissions after AD are frequent and resource-intensive, particularly within 90 days. Extending follow-up and focusing on high-risk groups, such as Medicaid/Medicare patients and those with pulmonary or renal disease, may help reduce this burden.