The George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC 20052, USA.
Division of Cardiovascular and Thoracic Surgery, Department of Surgery, University of Minnesota Medical School, 420 Delaware St. SE, MMC 207, Minneapolis, MN 55455, USA.
Alcohol Alcohol. 2024 Jul 21;59(5). doi: 10.1093/alcalc/agae061.
While alcohol consumption is implicated in the development of aortic dissection, the impact of alcohol use disorder (AUD) on the outcomes of type A aortic dissection (TAAD) repair is still largely unexplored. This study aimed to conduct a comprehensive, population-based analysis of effect of AUD on in-hospital outcomes following TAAD repair using National/Nationwide Inpatient Sample, the largest all-payer database in the United States.
Patients undergoing TAAD repair were identified in National/Nationwide Inpatient Sample from Q4 2015-2020. Demographics, comorbidities, hospital characteristics, primary payer status, and transfer-in status between patients with and without AUD were matched by a 1:3 propensity-score matching. In-hospital outcomes were examined.
There were 220 patients with AUD who underwent TAAD repair. Meanwhile, 4062 non-AUD patients went under TAAD repair, where 646 of them were matched to all AUD patients. After propensity-score matching, AUD patients had a lower risk of in-hospital mortality (7.76% vs 13.31%, P = 0.03) while there was no difference in transfer-in status or time from admission to operation. However, patients with AUD had a higher rate of respiratory complications (27.40% vs 19.66%, P = 0.02) and a longer hospital length of stay (16.20 ± 11.61 vs 11.72 ± 1.69 days, P = 0.01). All other in-hospital outcomes were comparable between AUD and non-AUD patients.
AUD patients had a lower risk of in-hospital mortality but a higher rate of respiratory complications and a longer LOS. These findings can provide insights into preoperative risk stratification of these patients. Nonetheless, reasons underlying the lower mortality rate in AUD patients and their long-term prognosis require further investigation.
尽管饮酒与主动脉夹层的发生有关，但酒精使用障碍（AUD）对A型主动脉夹层（TAAD）修复后结果的影响仍在很大程度上未被探索。本研究旨在使用美国最大的全支付者数据库国家/全国住院患者样本，对 AUD 对 TAAD 修复后住院期间结局的影响进行全面的基于人群的分析。
从 2015 年第四季度至 2020 年，在国家/全国住院患者样本中确定接受 TAAD 修复的患者。通过 1:3 倾向评分匹配，比较 AUD 患者和非 AUD 患者的人口统计学特征、合并症、医院特征、主要支付者状态和转入状态。检查住院期间的结果。
有 220 例 AUD 患者接受了 TAAD 修复。同时，4062 例非 AUD 患者接受了 TAAD 修复，其中 646 例与所有 AUD 患者匹配。在进行倾向评分匹配后，AUD 患者的住院期间死亡率较低（7.76% vs 13.31%，P=0.03），但转入状态或从入院到手术的时间没有差异。然而，AUD 患者的呼吸并发症发生率较高（27.40% vs 19.66%，P=0.02），住院时间较长（16.20±11.61 vs 11.72±1.69 天，P=0.01）。AUD 和非 AUD 患者的所有其他住院期间结局相似。
AUD 患者的住院期间死亡率较低，但呼吸并发症发生率较高，住院时间较长。这些发现可以为这些患者的术前风险分层提供参考。然而，AUD 患者死亡率较低的原因及其长期预后仍需要进一步研究。
