Non-White Race is an Independent Risk Factor for Hospitalization for Aortic Dissection.

OBJECTIVE: To evaluate racial differences in the burden of aortic dissection. DESIGN: Retrospective analysis of a comprehensive state-wide inpatient database. SETTING: Acute care hospitals in the state of Maryland, 2009 - 2014. PARTICIPANTS: All hospitalized adults with aortic dissection (AD), stratified by race. MAIN OUTCOME MEASURES: 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. CONCLUSION: 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.