Hospital Teaching Status and Outcomes in Type B Aortic Dissection: Analysis of More Than 40,000 Patients

Ahmad, D; Sá, MP; Brown, JA; Yousef, S; Wang, Y; Serna-Gallegos, D; West, D; Yoon, P; Kaczorowski, D; Bonatti, J; Chu, D; Ferdinand, FD; Phillippi, J; Sultan, I

doi:10.1053/j.jvca.2024.10.039

Hospital Teaching Status and Outcomes in Type B Aortic Dissection: Analysis of More Than 40,000 Patients

J Cardiothorac Vasc AnesthPublished 28 Oct 2024Retrospective cross-sectional study

Main finding · In-hospital mortalityResultOdds ratio 0.943 95% CI 0.841–1.057

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Authors' conclusion

Hospital teaching status alone was not associated with in-hospital mortality or 30-day readmission in TBAD patients.

Study context

Population: Patients with type B aortic dissection (TBAD), US hospitals, 2016–2020
Participants: 44,981 patients · 4,676 matched pairs

Exposure: Teaching vs nonteaching hospitals
Nonteaching (NT)n = 5,421reference
Tn = 39,470
Outcome: In-hospital mortality

Methodological detailsNational Readmissions Database, propensity score matched (1:1), multivariable regression

National Readmissions Database
Propensity score matched (1:1)
Multivariable regression

Main finding

As reported in the abstract

Odds ratio

0.943

95% CI 0.841–1.057

P = 0.31

By group

NT12.9%

T12.5%

T vs NT

OR 0.943 (95% CI 0.841–1.057); P = 0.31

Observational data: associations, not effects.

Further findings

30-day readmission · 30 days — NT vs T · propensity-matched

P = 0.12

NT23.3%

T21.8%

Outcome	← Lower odds with T ←→ Higher odds with T →	OR (95% CI)	P value
30-day readmission · 30 daysT vs NT · multivariable regression	0.512	0.965 (0.88–1.058)	P = 0.44
	0.512Odds ratio (log scale)

In-hospital mortality with thoracic endovascular aortic repair (TEVAR) at teaching hospitals

	← Lower odds ←→ Higher odds →	OR (95% CI)	P value
TEVAR	0.512	1.898 (1.596–2.257)	P < 0.01
	0.512Odds ratio (log scale)

30-day readmission by hospital volume at teaching hospitals

	← Lower odds ←→ Higher odds →	OR (95% CI)	P value
Volume quartile 3	0.512	1.488 (1.106–2.002)	P < 0.01
Volume quartile 4	0.512	1.684 (1.256–2.257)	P < 0.01
	0.512Odds ratio (log scale)

Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.

Original publication

Hospital Teaching Status and Outcomes in Type B Aortic Dissection: Analysis of More Than 40,000 Patients. J Cardiothorac Vasc Anesth. Published 28 October 2024. doi:10.1053/j.jvca.2024.10.039

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