title: Non-White Race is an Independent Risk Factor for Hospitalization for Aortic Dissection.
abstract: OBJECTIVE
  To evaluate racial differences in the burden of aortic dissection.
  
  
  METHODS
  Retrospective analysis of a comprehensive state-wide inpatient database.
  
  
  METHODS
  Acute care hospitals in the state of Maryland, 2009 - 2014.
  
  
  METHODS
  All hospitalized adults with aortic dissection (AD), stratified by race.
  
  
  METHODS
  Statewide and county-level population adjusted hospitalization rates, access to specialty aortic care, and mortality.
  
  
  RESULTS
  Of 3,719,412 admissions to Maryland hospitals during the study period, 3,190 had AD (.09%; 1665 White, 1525 non-White). Non-White race was more common in patients with AD than without (48% vs. 41%, P<.0001). Adjusted for statewide demographics, admission for AD was 1.4 times more common among non-Whites (11 vs. 8 per 100,000, P<.0001). Non-White race was an independent risk factor for AD admission (OR 1.5, 95% CI 1.4 - 1.7). Among patients with AD, non-Whites were younger and more often female, but had similar or lower rates of cardiovascular comorbidities. Non-White race was not associated with decreased access to care or increased mortality.
  
  
  CONCLUSIONS
  Hospitalization for AD is more common among non-Whites, who develop AD at younger ages despite fewer comorbidities. While clinical correlates are limited from this dataset, this may reflect more severe pathophysiology related to clinical or socioeconomic factors among non-Whites. Further study is warranted to better define this disparity and identify high-risk subgroups who may benefit from aggressive primary prevention.
authors.affiliation: Department of Surgery, Division of Vascular Surgery, University of Maryland School of Medicine.
authors.forename: Donald
authors.initials: D
authors.lastname: Harris
authors.affiliation: Department of Surgery, Division of Vascular Surgery, University of Maryland School of Medicine.
authors.forename: Elena
authors.initials: E
authors.lastname: Klyushnenkova
authors.affiliation: Department of Surgery, Division of Vascular Surgery, University of Maryland School of Medicine.
authors.forename: Richa
authors.initials: R
authors.lastname: Kalsi
authors.affiliation: Department of Surgery, Division of Vascular Surgery, University of Maryland School of Medicine.
authors.forename: Danon
authors.initials: D
authors.lastname: Garrido
authors.affiliation: Department of Surgery, Division of Vascular Surgery, University of Maryland School of Medicine.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Bhardwaj
authors.affiliation: R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine.
authors.forename: Joseph
authors.initials: J
authors.lastname: Rabin
authors.affiliation: Department of Surgery, Division of Vascular Surgery, University of Maryland School of Medicine.
authors.forename: Shahab
authors.initials: S
authors.lastname: Toursavadkohi
authors.affiliation: R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine.
authors.forename: Jose
authors.initials: J
authors.lastname: Diaz
authors.affiliation: Department of Surgery, Division of Vascular Surgery, University of Maryland School of Medicine.
authors.forename: Robert
authors.initials: R
authors.lastname: Crawford
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000784:Aortic Dissection / Q000208:ethnology*; D015897:Comorbidity; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008396:Maryland; D008875:Middle Aged; D044469:Racial Groups; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors
keywords: Aortic Dissection; Cardiovascular Disease; Disparity