Patients from distressed communities have decreased survival after open thoracic aneurysm repair.

OBJECTIVE

This study investigates the relationship between the Distressed Communities Index and long-term mortality in thoracic aortic aneurysm repair.

METHODS

This single-center retrospective study includes patients who underwent open thoracic aortic aneurysm repair between 2005 and 2021. The Distressed Communities Index served as a metric for socioeconomic status by providing distress scores for each patient's zip code. Patients were placed into the nondistressed group with a score of 50 or less or the distressed group with a score greater than 50. The primary outcome of this study was 10-year mortality. Multivariable Cox regression evaluated factors associated with long-term mortality while accounting for patient demographics and operative characteristics.

RESULTS

Of 1317 patients, 31% (n = 409) comprised the distressed group, which had higher rates of hypertension ( = .002), chronic obstructive pulmonary disease ( = .03), diabetes ( = .008), cerebrovascular disease ( = .04), and chronic kidney disease ( = .04). This group also experienced higher rates of surgical site infection ( = .02), postoperative respiratory failure ( = .006), and longer hospital stays ( < .001), as well as decreased survival probability at 1 year ( < .001) and beyond ( = .03). Multivariable logistic regression revealed that being in the distressed group was independently associated with increased long-term mortality risk (hazard ratio, 1.66;  = .005).

CONCLUSIONS

Being from a distressed community is associated with worse long-term mortality after thoracic aortic aneurysm repair. Socioeconomic status should be considered in surgical planning to improve patient outcomes and dismantle healthcare disparities.