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Abstract 11711: Factors Predicting Acute Ischemic Stroke Following Surgical Repair of Acute Type A Aortic Dissection (ATAAD) in Adults

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Introduction: Acute type A Aortic dissection (ATAAD) may require urgent surgical repair, and a major complication is acute ischemic stroke (AIS) post-surgery. Aim: To explore characteristics associated with AIS in ATAAD patients post-surgical repair (PSR). Hypothesis: We assessed the hypothesis that multiple factors influence events of AIS in ATAAD patients PSR. Method: Multivariate regression analysis for factors influencing AIS in adults with a principal diagnosis of ATAAD and undergoing surgical repair was performed via the 2016-2020 National Inpatient Sample. Results: Among the 20335 ATAAD cases with surgical repair, 14.7%(2985 cases) reported an event of AIS. Individuals ≥60 years (vs. ages 18-39 years, aOR 1.323, p=0.007) and presence of hypertension (aOR 1.228, P<.001), acute kidney injury (AKI) (aOR 1.353, P<.001), Charlson Comorbidity Index (CCI) ≥3 (aOR 15.129, p<.001), and Private insurances (vs. Medicare, aOR 1.454, p<.001) or Medicaid (vs. Medicare, aOR 1.673, p<.001) showed higher odds of developing AIS. On the contrary, smoking (aOR 0.613, p<.001), obesity (aOR 0.882, p=0.027), cirrhosis (aOR 0.309, p<.001), dyslipidemia (aOR 0.732, p<.001), diabetes (DM) (aOR 0.508, p<.001), peripheral vascular disease (PVD) (aOR 0.615, p<.001), Chronic Kidney Disease (CKD) (aOR 0.446, p<.001), prior MI (aOR 0.461, p<.001) and prior stroke (aOR 0.788, p=0.04) and Black race (aOR 0.736, p<.001) indicated lower odds. No significant difference was seen in age 40-59 (aOR 1.06, p=0.545), drug abuse (aOR 1.093, p=0.451), alcohol abuse (aOR 0.925, p=0.476), Females (vs. Males, aOR 0.973, p=0.579), and Hispanics (vs. Whites, aOR 1.102, p=0.285). Conclusion: In conclusion, a 14.7% rate of AIS in ATAAD PSR was observed. Ages ≥60, hypertension, AKI, CCI ≥3, and Private and Medicaid insurance holders appeared prone to AIS following such events, while smoking, obesity, cirrhosis, dyslipidemia, DM, PVD, CKD, prior MI, prior stroke, and Blacks had reduced odds.
Ovid Technologies (Wolters Kluwer Health)
Prince K Pekyi-Boateng Isaac Prempeh George Blankson Rex Bonsu Babbel Agbinko-Djobalar Nana Agyeman Badu Balkiranjit Kaur Dhillon Rahat A Memon Nadia I Wuni George Blewusi Derick Boateng Smith Frimpong petras lohana Joshua Asempa Stephen K Gbekor EWURADJOA AYIREBI-ACQUAH Hamilton Abimbilla Richmond Buckner Kwame Adjei-Sefah Patrick D Pekyi-Boateng Hemamalini Sakthivel Kamleshun Ramphul Fiifi Duodu
Circulation
2023
Title: Abstract 11711: Factors Predicting Acute Ischemic Stroke Following Surgical Repair of Acute Type A Aortic Dissection (ATAAD) in Adults
Description:
Introduction: Acute type A Aortic dissection (ATAAD) may require urgent surgical repair, and a major complication is acute ischemic stroke (AIS) post-surgery.
Aim: To explore characteristics associated with AIS in ATAAD patients post-surgical repair (PSR).
Hypothesis: We assessed the hypothesis that multiple factors influence events of AIS in ATAAD patients PSR.
Method: Multivariate regression analysis for factors influencing AIS in adults with a principal diagnosis of ATAAD and undergoing surgical repair was performed via the 2016-2020 National Inpatient Sample.
Results: Among the 20335 ATAAD cases with surgical repair, 14.
7%(2985 cases) reported an event of AIS.
Individuals ≥60 years (vs.
ages 18-39 years, aOR 1.
323, p=0.
007) and presence of hypertension (aOR 1.
228, P<.
001), acute kidney injury (AKI) (aOR 1.
353, P<.
001), Charlson Comorbidity Index (CCI) ≥3 (aOR 15.
129, p<.
001), and Private insurances (vs.
Medicare, aOR 1.
454, p<.
001) or Medicaid (vs.
Medicare, aOR 1.
673, p<.
001) showed higher odds of developing AIS.
On the contrary, smoking (aOR 0.
613, p<.
001), obesity (aOR 0.
882, p=0.
027), cirrhosis (aOR 0.
309, p<.
001), dyslipidemia (aOR 0.
732, p<.
001), diabetes (DM) (aOR 0.
508, p<.
001), peripheral vascular disease (PVD) (aOR 0.
615, p<.
001), Chronic Kidney Disease (CKD) (aOR 0.
446, p<.
001), prior MI (aOR 0.
461, p<.
001) and prior stroke (aOR 0.
788, p=0.
04) and Black race (aOR 0.
736, p<.
001) indicated lower odds.
No significant difference was seen in age 40-59 (aOR 1.
06, p=0.
545), drug abuse (aOR 1.
093, p=0.
451), alcohol abuse (aOR 0.
925, p=0.
476), Females (vs.
Males, aOR 0.
973, p=0.
579), and Hispanics (vs.
Whites, aOR 1.
102, p=0.
285).
Conclusion: In conclusion, a 14.
7% rate of AIS in ATAAD PSR was observed.
Ages ≥60, hypertension, AKI, CCI ≥3, and Private and Medicaid insurance holders appeared prone to AIS following such events, while smoking, obesity, cirrhosis, dyslipidemia, DM, PVD, CKD, prior MI, prior stroke, and Blacks had reduced odds.
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