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

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.