Key result
Lower socioeconomic status shows no significant association with increased early or midterm mortality.
Why the study?
Type A aortic dissection repair carries high perioperative and postoperative risk, but the influence of socioeconomic status on postoperative outcomes was unclear.
Does at-risk socioeconomic status (DCI score ≥75) worsen postoperative outcomes and survival in adults undergoing acute Type A aortic dissection repair?
Cohort (n=240)
No
Does at-risk socioeconomic status (DCI score ≥75) worsen postoperative outcomes and survival in adults undergoing acute Type A aortic dissection repair?
Hazard Ratio: 1.59 (95% CI 0.73–3.47)
p-value: p=0.25
Socioeconomic distress does not significantly worsen early or midterm survival following acute Type A aortic dissection repair, suggesting that urgent surgical intervention may help mitigate socioeconomic disparities in healthcare access for this acute pathology.
Acute type A aortic dissection repair may equalize early and midterm survival across socioeconomic groups; leaves open long-term DCI effects and other disparities.
Objective: Type A aortic dissection repair is an emergency operation associated with both higher perioperative and postoperative risk. This study investigates the influence of socioeconomic status, as measured by the Distressed Communities Index (DCI), on patients who underwent acute aortic dissection repair and their postoperative outcomes. Methods: We conducted a retrospective analysis of 240 adult patients who underwent repair for acute Stanford Type A aortic dissection from 2009 to 2021. Patients were categorized into an at-risk group (DCI score ≥75) and a not-at-risk group (DCI score <75) based on their zip code. We collected demographic, clinical, operative, and postoperative outcomes, analyzing data using descriptive statistics and multivariable logistic regression. Kaplan-Meier survival analysis assessed 5-year survival outcomes. Results: = .43). Conclusions: Patients undergoing urgent surgery for acute Type A aortic dissection have similar postoperative outcomes, although at-risk patients may experience longer hospital stays and higher respiratory failure rates. Further study is necessary to understand the effect of DCI score on intermediate and long-term outcomes to mitigate social disparities and diminish modifiable risk factors.
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Hambright et al. (2025) conducted a cohort in Acute Stanford Type A aortic dissection (n=240). Lower socioeconomic status (Distressed Communities Index score ≥75) vs. Higher socioeconomic status (Distressed Communities Index score <75) was evaluated on Early phase mortality (<6 months) (HR 1.59, 95% CI 0.73-3.47, p=0.25). Lower socioeconomic status, as measured by a Distressed Communities Index score ≥75, did not significantly increase early-phase mortality (HR 1.59) or midterm mortality compared to higher socioeconomic status.
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