Ruptured abdominal aortic aneurysm (AAA) is a medical emergency that requires immediate surgical intervention. The aim of this analysis was to identify the sex- and race-specific disparities that exist in outcomes of patients hospitalized with this condition in the United States using the National Inpatient Sample (NIS) to identify targets for improvement and support of specific patient populations. In this descriptive, retrospective study, we analyzed the patients admitted with a primary diagnosis of ruptured AAA between January 1, 2016, and December 31, 2020, using the NIS database. We compared demographics, comorbidities, and in-hospital outcomes in AAA patients, and compared these results between different racial groups and sexes. A total of 22,395 patients with ruptured AAA were included for analysis. Of these, 16,125 patients (72.0%) were male, and 6270 were female (28.0%). The majority of patients (18,655 [83.3%]) identified as Caucasian, with the remaining patients identifying as African American (1555 [6.9%]), Hispanic (1095 [4.9%]), Asian or Pacific Islander (470 [2.1%]), or Native American (80 [0.5%]). Females had a higher risk of mortality than males (OR, 1.7; 95% confidence interval [CI], 1.45-1.96; < .001) and were less likely to undergo endovascular aortic repair (OR, 0.70; 95% CI, 0.61-0.81; < .001) or fenestrated endovascular aortic repair (OR, 0.71; 95% CI, 0.55-0.91; = .007). Relative to Caucasian race, patients who identified as African American had a lower risk of inpatient mortality (OR, 0.50; 95% CI, 0.37-0.68; < .001). In this retrospective study of the NIS database from 2016 to 2020, females were less likely to undergo endovascular intervention and more likely to die during their initial hospitalization. African American patients had lower rates in-hospital mortality than Caucasian patients, despite a higher burden of comorbidities. Future studies are needed to elucidate the potential factors affecting racial and sex disparities in ruptured AAA outcomes, including screening practices, rupture risk stratification, and more personalized guidelines for both elective and emergent intervention.

中文翻译：

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美国腹主动脉瘤破裂患者住院结局的种族和性别差异

腹主动脉瘤破裂 (AAA) 是一种医疗紧急情况，需要立即进行手术干预。本分析的目的是使用全国住院患者样本 (NIS) 来确定美国因这种疾病住院的患者结局中存在的性别和种族差异，以确定改善和支持特定患者群体的目标。在这项描述性回顾性研究中，我们使用 NIS 数据库分析了 2016 年 1 月 1 日至 2020 年 12 月 31 日期间因初步诊断为 AAA 破裂而入院的患者。我们比较了 AAA 患者的人口统计学、合并症和住院结果，并比较了不同种族和性别之间的这些结果。共有 22,395 名 AAA 破裂患者被纳入分析。其中，16,125 例患者（72.0%）为男性，6270 例为女性（28.0%）。大多数患者 (18,655 [83.3%]) 被确定为白种人，其余患者被确定为非裔美国人 (1555 [6.9%])、西班牙裔 (1095 [4.9%])、亚洲或太平洋岛民 (470 [2.1%]) ），或美洲原住民（80 [0.5%]）。女性的死亡风险高于男性（OR，1.7；95% 置信区间 [CI]，1.45-1.96；< .001），并且接受血管内主动脉修复术的可能性较小（OR，0.70；95% CI，0.61- 0.81；< .001）或开窗主动脉腔内修复术（OR，0.71；95% CI，0.55-0.91；= .007）。相对于白种人种，非裔美国人患者的住院死亡风险较低（OR，0.50；95% CI，0.37-0.68；< .001）。在这项对 2016 年至 2020 年 NIS 数据库的回顾性研究中，女性接受血管内介入治疗的可能性较小，并且在初次住院期间死亡的可能性更大。尽管合并症负担较高，但非洲裔美国患者的院内死亡率低于白人患者。未来的研究需要阐明影响 AAA 破裂结果中种族和性别差异的潜在因素，包括筛查实践、破裂风险分层以及针对选择性和紧急干预的更个性化的指南。